2014 Bluestone Lane - Inspection Form11 1110 111 —
City BI tal,ao
Residential Sanitary Sewer Service
• •
Compliance Inspection
DateIJ j,;"1 ,7162
-A/Vrt?7 Disk #
Name
PID Number
House Number , e--?(- 2 -/ej Street Name A.."/
Alternative Mailing Address
,
OwnerlOccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
4 No sump pump
Service Lateral Inspection Findings
Roots' 1
Poor Pipe Joints
Mineral Deposits e--
7/
its 14---r
Sag/Pipe Deflection
Damaged Pipe
Transition i "v"
4" to 6" Transition:
White Copy: Property Owner
■■••=.1.1.
Time 4
Number of stacks
Non-Compliance
For information call 651.470.2788
i f
Clear water connections t
sanitary sewer i.,.. 5
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
r
Time / • Or V
• pm
Phone t 4,'")(f_i 75
/ rpsp4E Signature
Obstruction
Unable to push past
feet
Entered SLat J74cif_
7 ii
1 1) rT7
(o AT LK,"
Final Cleanout:
' / 6 1- C , CV r /
Na Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Notes (:.() o/e1 /722
/
77 4,5
Pink Copy: SEH
Number
Correctly
Discharged
incorrectly
Unknown
Total
Sump pumps
Foundation drains
t
Roof drains
-----......-
--;"-- i
4 --,- , -
11 1110 111 —
City BI tal,ao
Residential Sanitary Sewer Service
• •
Compliance Inspection
DateIJ j,;"1 ,7162
-A/Vrt?7 Disk #
Name
PID Number
House Number , e--?(- 2 -/ej Street Name A.."/
Alternative Mailing Address
,
OwnerlOccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
4 No sump pump
Service Lateral Inspection Findings
Roots' 1
Poor Pipe Joints
Mineral Deposits e--
7/
its 14---r
Sag/Pipe Deflection
Damaged Pipe
Transition i "v"
4" to 6" Transition:
White Copy: Property Owner
■■••=.1.1.
Time 4
Number of stacks
Non-Compliance
For information call 651.470.2788
i f
Clear water connections t
sanitary sewer i.,.. 5
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
r
Time / • Or V
• pm
Phone t 4,'")(f_i 75
/ rpsp4E Signature
Obstruction
Unable to push past
feet
Entered SLat J74cif_
7 ii
1 1) rT7
(o AT LK,"
Final Cleanout:
' / 6 1- C , CV r /
Na Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Notes (:.() o/e1 /722
/
77 4,5
Pink Copy: SEH