2074 Bluestone Dr E - Inspection FormCit.,y of Ja.ptl
Residential Sanitary Sewer Service
Compliance Inspection
Date _ I / J / J )
Name ) 1� 1
PID Number
Compliance
0 No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
am
Time ® pm
House Number ^ — Street Name _ ;. !r Jy*��"
Phone l `
r
Alternative Mailing Address
),1,'\
i Ow'!Occupant Signature
Transition
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Time
inspector Signature
For information .call 65
Obstruction
Unable to push past
feet
Sag /Pipe Deflection - i } f - � '
Damaged Pipe - --� !! f#�',
Service Lateral Inspection Findings Number of stacks _ ` Entered S..L..at
Final Cleanout:
am
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots )
I
Poor PipeJoints f' .7 lr'i ' r� ° ;� 1 `�—� - J _. (2' � r
Mineral Deposits
P /)
--r
Pink Copy: SEH
Number
Correctly
Notes
Discharged
Total
Incorrectly
Unknown
6.1 1 ' /" ii l '� ' �- `` ' 1
j ' I !
}
Sump pumps
r �.
Foundation drains
Roof drains
�f
Cit.,y of Ja.ptl
Residential Sanitary Sewer Service
Compliance Inspection
Date _ I / J / J )
Name ) 1� 1
PID Number
Compliance
0 No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
am
Time ® pm
House Number ^ — Street Name _ ;. !r Jy*��"
Phone l `
r
Alternative Mailing Address
),1,'\
i Ow'!Occupant Signature
Transition
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Time
inspector Signature
For information .call 65
Obstruction
Unable to push past
feet
Sag /Pipe Deflection - i } f - � '
Damaged Pipe - --� !! f#�',
Service Lateral Inspection Findings Number of stacks _ ` Entered S..L..at
Final Cleanout:
am
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots )
I
Poor PipeJoints f' .7 lr'i ' r� ° ;� 1 `�—� - J _. (2' � r
Mineral Deposits
P /)
--r
Pink Copy: SEH
Sump pumps
Foundation drains
Roof drains
_ �,
41. City of i;a an
y �
Residential Sanitary Sewer Service
Compliance Inspection
Dateti: j- <751 f
Name
:}
PID Number
House Number y.�° E.�' `Street Name
Alternative Mailing Address
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
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
4" to 6 "Transition:
1
Transition
White Copy: Property Owner
Time •
Disk
am
pm
Ownerlbccupant Signature
Service Lateral inspection Findings
Roots )..w�
Poor PipeJoints
if
Total
Number Discharged
Correctly
Length of Service:
Incorrectly
Unknown
Yellow Copy: City of Eagan
« r-P
Phone
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Reco rd Number - '
Ji
, f' . • ` o pm
Obstruction
Unable to push past
feet.
Notes
.w_ i
lnspecror Signature
O Flexible sump pump piping
/ ,1
Number of stacks 1 Entered S L at -- ,t
1
Final Cleanout:
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f
�,. -2;
Pink Copy: SEH