2140 Shale Lane - Inspection FormCity of C,aar
Residential Sanitary Sewer Service
Compliance Inspection
Dat
Name
PID Number
}} -1
House Number l � � Street Name
Alternative Mailing Address
Disk
JN i
Owner /Occupant Signature
pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
$1 No sump pump
4" to 6 "Transition:
White Copy: Property Owner
� am
Time . pm
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 7 /7 ; ?, f � -'7 � r `� i j � .
Yellow Copy: City of Eagan
Record Number
Phone )
Time (, .._-"
•
® _ o prr
Inspector Signature
For information call 651.470.2788
Obstruction I No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
r efus ed
Service LateraJnspection Findings Number of stacks 1 Entered St .at
Roots ! . -r'
Poor Pipe Joints
Final Cleanout: ''''
Pink Copy: SEH
Total
Notes
���:7 LS
Number.
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City of C,aar
Residential Sanitary Sewer Service
Compliance Inspection
Dat
Name
PID Number
}} -1
House Number l � � Street Name
Alternative Mailing Address
Disk
JN i
Owner /Occupant Signature
pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
$1 No sump pump
4" to 6 "Transition:
White Copy: Property Owner
� am
Time . pm
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 7 /7 ; ?, f � -'7 � r `� i j � .
Yellow Copy: City of Eagan
Record Number
Phone )
Time (, .._-"
•
® _ o prr
Inspector Signature
For information call 651.470.2788
Obstruction I No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
r efus ed
Service LateraJnspection Findings Number of stacks 1 Entered St .at
Roots ! . -r'
Poor Pipe Joints
Final Cleanout: ''''
Pink Copy: SEH