4289 Sandstone Dr - Inspection Formdi*
Lay Eapa
a
Residential Sanitary Sewer Service
Compliance Inspection
Dated i / )(�
Name / \\ )4.
Disk # /
{
PID Number
House Number G�- � Street Name
am
Time 0 pm
'l vil «t /+ r ni(i l 1
�.E
Owner /Occupant Signature
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Pod Pipqjoints
Mine a eposits
Sag /Pi Deflection
Dan age0 Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
Yellow Copy: City of Eagan
Record Number
//)• am
Time l J O prn
•
Phone
inspector Signature
Obstruction
Unable to push past
feet
)7
No Access
O No one in
O Inspection
refused
Access to service
lateral needed
Entered S at -=
1 - w ' '
/ �---
- 7 1- C1 ) , e257172
Length of Service: - Final Cleanout: —°—
Pink Copy: SEH
Total
Notes
//
n
Number
Discharged
Correctly
Incorrectly
Unkno
Sump pumps
Foundation drains
Roof drains
di*
Lay Eapa
a
Residential Sanitary Sewer Service
Compliance Inspection
Dated i / )(�
Name / \\ )4.
Disk # /
{
PID Number
House Number G�- � Street Name
am
Time 0 pm
'l vil «t /+ r ni(i l 1
�.E
Owner /Occupant Signature
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Pod Pipqjoints
Mine a eposits
Sag /Pi Deflection
Dan age0 Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
Yellow Copy: City of Eagan
Record Number
//)• am
Time l J O prn
•
Phone
inspector Signature
Obstruction
Unable to push past
feet
)7
No Access
O No one in
O Inspection
refused
Access to service
lateral needed
Entered S at -=
1 - w ' '
/ �---
- 7 1- C1 ) , e257172
Length of Service: - Final Cleanout: —°—
Pink Copy: SEH