2083 Coral Lane - Inspection FormCity of Fa ai
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name )°7y� Disk #
PID Number
House Number
Alternative Mailing Address
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
/ " 9
Owner /Occupant Signature
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
White Copy: Property Owner
;rp
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
1
Length of Service:
Yellow Copy: City of Eagan
Record Number
• S treet Name
Phone 27) — �,�
0 am
Time • _o pm
lnspectornature
For information call 65 1.47112788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered 5 L at
Roots
2
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Insp .'f)
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
Foundation drains
Roof drains
City of Fa ai
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name )°7y� Disk #
PID Number
House Number
Alternative Mailing Address
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
/ " 9
Owner /Occupant Signature
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
White Copy: Property Owner
;rp
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
1
Length of Service:
Yellow Copy: City of Eagan
Record Number
• S treet Name
Phone 27) — �,�
0 am
Time • _o pm
lnspectornature
For information call 65 1.47112788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered 5 L at
Roots
2
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Insp .'f)
refused
Pink Copy: SEH