3625 Great Oaks Cir - Inspection Formr7 c
i
Residential Sanitary Sewer Service
Compliance inspection
3 �7 k f • �� a Date 1_.I Time p
i
s r- ✓1 -
Name / a 11 / I - - Y% Disk#
PID Number
/j -
House Number . '� Street Name /
-"
Alternative Mailing Address
For information call 65
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
' sanitary sewer
O Sump pump properly piped
O No sump pump
Transition
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection_
Damaged Pipe
r :t
. 7I
4" to 6"Transition: (
White Copy: Property Owner
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
Number of stacks -!� Entered St at - •
•
Length of Service:
Record Number
°Time
•
7 ,
Phone / 47
inspector Signature
Obstruction
Unable to push past
feet
j..
,o,am
Pm
No Access
O No one in
r f
O Access to service
lateral needed
O Inspection
refused
—`` • Final Cleanout: - �'
Notes
'71
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
1 ' 1'- i v
- "
f 1 a
!
i 10
(9
,
i.i
Foundation drains
Roof drains
r7 c
i
Residential Sanitary Sewer Service
Compliance inspection
3 �7 k f • �� a Date 1_.I Time p
i
s r- ✓1 -
Name / a 11 / I - - Y% Disk#
PID Number
/j -
House Number . '� Street Name /
-"
Alternative Mailing Address
For information call 65
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
' sanitary sewer
O Sump pump properly piped
O No sump pump
Transition
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection_
Damaged Pipe
r :t
. 7I
4" to 6"Transition: (
White Copy: Property Owner
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
Number of stacks -!� Entered St at - •
•
Length of Service:
Record Number
°Time
•
7 ,
Phone / 47
inspector Signature
Obstruction
Unable to push past
feet
j..
,o,am
Pm
No Access
O No one in
r f
O Access to service
lateral needed
O Inspection
refused
—`` • Final Cleanout: - �'
Notes
'71
Yellow Copy: City of Eagan Pink Copy: SEH