2128 Shale Lane - Inspection FormSump pumps
_
..._-_--- —
,..--
---
drains
1c Foundation
Roof drains
4160.
till of Eapa
Residential Sanitary Sewer Service
oni
C phance Inspection
Date 2 Z /9 / /a
Name
/ 42 Z-- Disk #
7 ..gf
Time (-/- • 0 Pm
PID Number
House Number /7 Street Name ilV4:64 44/
.4
-7 /E)
Alternative Mailing Address . ....—.
' i --; - 74..„.-- Phon I .
// /4„. .„,
/
V./-•
//inspector Signature
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
1(No sump pump
0
7
For irriot-rylatiort call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks
Roots
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Total
(- c-7-- tic K-10
)
Number Discharged
Correctly
Incorrectly
Yellow Copy: City of Eagan
9
Length of Ser vice:
Unknown
[Lid
Record Number
Obstruction
U e to push past
feet
F
/,/
Entered S L at
/
Time '---
•
rn
• 0 p
Final Cleanout:
No Access
O No one in
offin vitry AT'
ID Access to service
lateral needed
O Inspection
refused
Notes 14..)
(1 -1//1 f," 7 '6.
VA/ M(2.•
• ,
-t)f
,
,sL Pink Copy: SEH
/ 7 1 :fiA1/6;c
A i 6
U-••• • L.7