4241 Sandstone Dr - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
2 / ;' / /
House Number
Alternative Mailing Address
/./ �---
Tr
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
ki No sump pump
Sag /Pipe Deflection _
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Pr open ty Owner
4// • O am
Time / At pm
Date 4 7 /-• ! 7U
Name Li c .l4.f
PID Number
Disk # [j
Street Name
OwnerlOcofp a'{t Signature
LIJ-
M
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
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Length of Service:
Record Number
Time
�' (fir' 11
PSdne 1
l !' ///
Ttt,
/l Signature
For information call 651.470.2788
Unable to push past
feet
Entered S. L at
t
7?
Notes
Final Cleanout:
— , > e
•
•
o am
o pm
No Access
O No one in
'42: lateral needed
Access to service
O inspection
refused
73
eV %
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
"
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
2 / ;' / /
House Number
Alternative Mailing Address
/./ �---
Tr
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
ki No sump pump
Sag /Pipe Deflection _
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Pr open ty Owner
4// • O am
Time / At pm
Date 4 7 /-• ! 7U
Name Li c .l4.f
PID Number
Disk # [j
Street Name
OwnerlOcofp a'{t Signature
LIJ-
M
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
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Length of Service:
Record Number
Time
�' (fir' 11
PSdne 1
l !' ///
Ttt,
/l Signature
For information call 651.470.2788
Unable to push past
feet
Entered S. L at
t
7?
Notes
Final Cleanout:
— , > e
•
•
o am
o pm
No Access
O No one in
'42: lateral needed
Access to service
O inspection
refused
73
eV %
Yellow Copy: City of Eagan Pink Copy: SEH