4345 Diamond Dr - Inspection FormRes i i
idental Sanitary Sewer Servic
Compliance Inspection
Date
Name J\
House Number
PO Number
Alternative Mailing Address
Time •
am
Pm
J7/124 Disk # M 4_1_1
..)Street Name •
-
• --
Owner/Occupant Signature
Record Number
Phone
Time
o am
•
• 0 Pin
Inspector Signature
For information tali 651
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
4" to 6" Transition:
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
Obstruction
Unable to push past
feet
Service Lateral inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
White Copy: Proper Owner
Length of Service: Final Cleanout:
Notes
ccess
No one in
O Access to service
lateral needed
O Inspection
r efused
Yellow Copy: City of Eagan Pink Copy: SEM
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
Res i i
idental Sanitary Sewer Servic
Compliance Inspection
Date
Name J\
House Number
PO Number
Alternative Mailing Address
Time •
am
Pm
J7/124 Disk # M 4_1_1
..)Street Name •
-
• --
Owner/Occupant Signature
Record Number
Phone
Time
o am
•
• 0 Pin
Inspector Signature
For information tali 651
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
4" to 6" Transition:
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
Obstruction
Unable to push past
feet
Service Lateral inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
White Copy: Proper Owner
Length of Service: Final Cleanout:
Notes
ccess
No one in
O Access to service
lateral needed
O Inspection
r efused
Yellow Copy: City of Eagan Pink Copy: SEM
City or Ea an
Residential : Sanitary Sewer Service
Compliance inspection
Date I, 1 I(� Time _ �7 •�
Name /
/ /1 .„..„1 7t ? i Disk #
PID Number
House Number. - \Street Name
Alternative Mailing Address
774
f i g No roof drain connection
O Sump pit not connected to
sanitary sewer
fi O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
OwnerlC'sat ant Signature
o pliance
No foundation drain connection
Service Lateral lnspection Findin
Roots
am
Pm
For information 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
,( Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 2 (
Length of Service: "
Yellow Copy: City of Eagan
Record Number
I �•
Notes
Phone
. •
Time
}
;y
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
0 a
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at - "' -
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
/ 'J
Roof drains
City or Ea an
Residential : Sanitary Sewer Service
Compliance inspection
Date I, 1 I(� Time _ �7 •�
Name /
/ /1 .„..„1 7t ? i Disk #
PID Number
House Number. - \Street Name
Alternative Mailing Address
774
f i g No roof drain connection
O Sump pit not connected to
sanitary sewer
fi O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
OwnerlC'sat ant Signature
o pliance
No foundation drain connection
Service Lateral lnspection Findin
Roots
am
Pm
For information 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
,( Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 2 (
Length of Service: "
Yellow Copy: City of Eagan
Record Number
I �•
Notes
Phone
. •
Time
}
;y
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
0 a
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at - "' -
Pink Copy: SEH