852 Great Oaks Tr - Inspection FormCiit of lia ai
Residential Sanitary Sewer Service
Compliance Inspection
fi
eDate r -._ 1 / ,
Name Z i eJA % W-K7, k. Disk #
PID Number
House Number - Street Name
Alternative Mailing Address
Roots
Compliance
f" No foundation drain connection
rr
No roof drain connection
tp Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
j i No sump pump
Service Lateral Inspection Findings
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflectio
Damaged Pipe
�
Transition r 0'/k.
4" to 6" Transition:
White Copy: Property Owner
OwnerlOccupant Signature
/ 6 -7 a m
Time f •� • • O pm
LkJ
Jma
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 _
Length of Service:
1
Number Discharged
Sump pumps
Foundation drains
Roof drains
Total
Correctly
Incorrectly Unknown
Record Number
(
J
Notes
-Inspector Signature
/
Obstruction
Unable to push past
feet
--- ,-
Fina) Cleanout:
71.4s1 1� >, r
1 1 ® em
Time ® o pm
Pion e
41
For information` call 65 1A70.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Entered S.L at —
eiC (2 -C60
Yellow Copy: City of Eagan Pink Copy: SEH