2133 Shale Lane - Inspection FormCity of Eapo
Residential Sanitary Sewer Service
Compliance inspection
Compliance
4
ii5 No foundation drain connection
• No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Date !
.r-
Name
PID Number
House Number Street Name
Alternative Mailing Address
Service Lateral Inspection Findings
Poor Pipe Joints
White Copy: Property Owner
i
4" to 6" Transition: /
Time + •
•
Disk #
OwnerlOccupaht Signature
am
pm
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition _!- --r --
LLLLJ
1
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 .
Phone
Length of Service: ,,
Yellow Copy: City of Eagan
Record Number
j am
Time • 7 pm
Inspector Signature
Obstruction
Unable to push past
feet
For information call 651.470,2788
Entered S.L.at
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
}
Roots
Pink Copy: SEH
Notes
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
rr / / 0i
r
Foundation drains
f
Roof drains
City of Eapo
Residential Sanitary Sewer Service
Compliance inspection
Compliance
4
ii5 No foundation drain connection
• No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Date !
.r-
Name
PID Number
House Number Street Name
Alternative Mailing Address
Service Lateral Inspection Findings
Poor Pipe Joints
White Copy: Property Owner
i
4" to 6" Transition: /
Time + •
•
Disk #
OwnerlOccupaht Signature
am
pm
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition _!- --r --
LLLLJ
1
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 .
Phone
Length of Service: ,,
Yellow Copy: City of Eagan
Record Number
j am
Time • 7 pm
Inspector Signature
Obstruction
Unable to push past
feet
For information call 651.470,2788
Entered S.L.at
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
}
Roots
Pink Copy: SEH