4279 Amber Dr - Inspection FormCity of Eaao
Residential Sanitary Sewer Service
Compliance Inspection
Date()
Name f ' /t x0,4 �Pi ;,;. 1 Disk #
PID Number
House Number 1 -,27 ,5
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
• oam
Time • .&r pm
Street Name
Lt -
Alternative Mailing Address
OwnerlOccupant Signature
Ph ne _
-
For information call 651 .'
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 _ Entered S L at
Roots
Pool-Pipe Joints
Mineral Deposits
Sag /Pipe Deflection , ` 1 0
Damaged Pipe 174 j `'y /1 s7 11 -- - 7> = ( frz' 4 -r
Transition
J ,1
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet.
/VT
Time
f Inspector Signature
Final Cleanout:
• O am
• O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
4.1, f ,. /
o 4 67, .v^�
1 . v
_ y' / 7"
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
('''X }
Foundation drains
Roof drains
City of Eaao
Residential Sanitary Sewer Service
Compliance Inspection
Date()
Name f ' /t x0,4 �Pi ;,;. 1 Disk #
PID Number
House Number 1 -,27 ,5
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
• oam
Time • .&r pm
Street Name
Lt -
Alternative Mailing Address
OwnerlOccupant Signature
Ph ne _
-
For information call 651 .'
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 _ Entered S L at
Roots
Pool-Pipe Joints
Mineral Deposits
Sag /Pipe Deflection , ` 1 0
Damaged Pipe 174 j `'y /1 s7 11 -- - 7> = ( frz' 4 -r
Transition
J ,1
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet.
/VT
Time
f Inspector Signature
Final Cleanout:
• O am
• O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
4 16. City of Eqao
Residential Sanitary Sewer Service
Compliance Inspection
1 f 9 i r
Date- /
Name ;VI d
PID Number
J r'?
House Number / ' Street Name
Alternative Mailing Address
) \i f') '!?s- y' \
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
0 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O, No sump pump
Service Lateral Inspection
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1-4-
4" to 6" Transition:
Owner /Occupant Signature
White Copy: Pr opei.ty Own r
... -' .. rY 0 a
Time a c pm
!Disk #
Findings
rye%'
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
Sump pumps
Foundation drains
Roof drains
Total
Correctly
Number Discharged
✓.r
Record Number
Phone
Obstruction
Unable to push past
feet.
Entered S.L at
Notes
• 67 0 11 am
Time p pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of %; _ ' Final Cleanout:" l "
1
Yellow Copy: City of Eagan Pink Copy: SEH