4363 Rahn Rd - Inspection Form4111111 •
City ol Pap
Residential Sanitary Sewer Service
Compliance Inspection
Date Bc,,,2___L_Lz Time
Name ` gyp Disk #
PID Number
/ j r
House Number -= C '.. Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
on} pliance
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
Roots / 1 " :
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe f !
Transition . - I _7 ` "; - -r
4" to 6" Transition:
White Copy: Property Owner
am
pm
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
Length of Service:
Yellow Copy: City of Eagan
Record Number i
Phone
Entered S L at
am
Pal
Obstruction
Unable to push past
feet
•
Inspector Signature
f - Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
2
Pink Copy: SEH
Total
Notes
nn
��� )-5/14 '
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
1
Foundation drains
Roof drains
4111111 •
City ol Pap
Residential Sanitary Sewer Service
Compliance Inspection
Date Bc,,,2___L_Lz Time
Name ` gyp Disk #
PID Number
/ j r
House Number -= C '.. Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
on} pliance
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
Roots / 1 " :
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe f !
Transition . - I _7 ` "; - -r
4" to 6" Transition:
White Copy: Property Owner
am
pm
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
Length of Service:
Yellow Copy: City of Eagan
Record Number i
Phone
Entered S L at
am
Pal
Obstruction
Unable to push past
feet
•
Inspector Signature
f - Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
2
Pink Copy: SEH