2048 Shale Lane - Inspection Formr 1111 of Eapa[I
Residential Sanitary Sewer Service
Compliance Inspection
Alternative Mailing Address
Dat ! 1 /ice Time
•
7 � f
Name /._ .) 7i/s
pliance
No foundation drain connection
No roof drain connection
0 Sump pic not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspecti tyFindings
.--
Roots ,
4" to 6" Transition:
White Copy: Piopetty Owner
7/6
PID Number
)) House Number ry Street Name
Owrr r»Occupant Signature
i
am
pm
1
For information call 65 1:470.2788
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
Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition i?
� t �� � —477) ,�.. —�
Length of Service: e
Yellow Copy: City of Eagan
Record Number
Time
inspector Signature
Obstruction
Unable to push past
feet
Entered 5. L at _ ✓_
Final Cleanout:
am
t
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number.
Correctly
Discharged
Incorrectly
Unknown
Notes
Total
Sump pumps
II
Foundation drains
) c
Roof drains
r 1111 of Eapa[I
Residential Sanitary Sewer Service
Compliance Inspection
Alternative Mailing Address
Dat ! 1 /ice Time
•
7 � f
Name /._ .) 7i/s
pliance
No foundation drain connection
No roof drain connection
0 Sump pic not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspecti tyFindings
.--
Roots ,
4" to 6" Transition:
White Copy: Piopetty Owner
7/6
PID Number
)) House Number ry Street Name
Owrr r»Occupant Signature
i
am
pm
1
For information call 65 1:470.2788
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
Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition i?
� t �� � —477) ,�.. —�
Length of Service: e
Yellow Copy: City of Eagan
Record Number
Time
inspector Signature
Obstruction
Unable to push past
feet
Entered 5. L at _ ✓_
Final Cleanout:
am
t
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH