2120 Marble Lane - Inspection FormCity of Pa as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
.)4
// /,;)z; e 1
S _F �� Disk #
Time
PID Number
House Number i Street Name
Alternative Mailing Address
OwnerlOccupant Signature
o • Hance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
pm
)v 2/
) 2/
Non
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
Inspector Signature
For information call 651.470.2788
Number of stacks Entered S L at r
Roots
Poor Pipe Joints
Mineral Deposits
5 ,gripe Deflection
Damaged Pipe
I �
Transition r2/7
4" to 6 "Transition:
White Copy: Property Owner
_
}-r_- Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone e ) - i ' ) 9 -,-
Obstruction
Unable to push past
feet
1
'time —_r •
• 0 a
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Cleanout: (7
Pink Copy: SEH
0
Total
Note
„
--- --4(7). ' �'
- - t° - 1
_
_ :
r
C�i
I -
'
1
Number.
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
PP P
/----).)
Foundation drains
Roof drains
City of Pa as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
.)4
// /,;)z; e 1
S _F �� Disk #
Time
PID Number
House Number i Street Name
Alternative Mailing Address
OwnerlOccupant Signature
o • Hance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
pm
)v 2/
) 2/
Non
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
Inspector Signature
For information call 651.470.2788
Number of stacks Entered S L at r
Roots
Poor Pipe Joints
Mineral Deposits
5 ,gripe Deflection
Damaged Pipe
I �
Transition r2/7
4" to 6 "Transition:
White Copy: Property Owner
_
}-r_- Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone e ) - i ' ) 9 -,-
Obstruction
Unable to push past
feet
1
'time —_r •
• 0 a
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Cleanout: (7
Pink Copy: SEH
0