1510 Wellington Way - Inspection Formof Eapt
Resi ent ai. San _ Sewer Se ce
Compliance anc Inspection
Date / 1. 1f o
Name t / ?io
PID Number
House Number 1 S L)
Alternate Mailing Address
rr
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Transition
Owner /Occupant Signature
4" to 6" Transition:
White Copy: Property Owner
Time 9 :
Disk #
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
am
pm
Street Name
j
Yellow Copy: City of Eagan
Record Number 9/,-% 3 s 3
Obstruction
Unable to push past
feet
Time
Length of Service: / 4
Inspector Signature
Number of stacks Entered S.L. at 5 4
o am
o pm
Phone ` 215;9 =�C)
For Information call 651.470.2788
No Access
o No one in
o Access to service lateral
needed
O Inspection refused
C.
Poor Pipe Joints C� 57S f '.r
Mineral Deposits
Sag /Pipe Deflection ii ('
Damaged Pipe 1 13 , -Pc1 (Ft'
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651-222-1551
Total
Notes
µ
Number
Discharged
Correctly
Incorrectly Unknown
Sump Pumps
Foundation Drains
in
MEM
---
Roof Drains
of Eapt
Resi ent ai. San _ Sewer Se ce
Compliance anc Inspection
Date / 1. 1f o
Name t / ?io
PID Number
House Number 1 S L)
Alternate Mailing Address
rr
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Transition
Owner /Occupant Signature
4" to 6" Transition:
White Copy: Property Owner
Time 9 :
Disk #
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
am
pm
Street Name
j
Yellow Copy: City of Eagan
Record Number 9/,-% 3 s 3
Obstruction
Unable to push past
feet
Time
Length of Service: / 4
Inspector Signature
Number of stacks Entered S.L. at 5 4
o am
o pm
Phone ` 215;9 =�C)
For Information call 651.470.2788
No Access
o No one in
o Access to service lateral
needed
O Inspection refused
C.
Poor Pipe Joints C� 57S f '.r
Mineral Deposits
Sag /Pipe Deflection ii ('
Damaged Pipe 1 13 , -Pc1 (Ft'
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651-222-1551