2088 Shale Lane - Inspection Form)qt)D9
City ill lia R
Residential Sanitary Sewer Service
Compliance Inspection
Date (72/ 271 1C7 Time ! :J72
Name 7' 7 ,sue Disk #
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupa gnature
Compliance
i 10 foundation drain connection
r No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
$' No sump pump
Service Lateral Inspection Findings
0
o am
0f-Pm
Street Name
1
[Id
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
Record Number
Number of stacks t Entered S L at
Length of Service:
Yellow Copy: City of Eagan
._---
<V n'
Time a pm
Phone
j
= / Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor PipeJoints
Mineral Deposits
fr
Sag /Pipe Deflection
Damaged Pipe / /71-:id-1/ ,�- --
Transition L/ 1 / c�l ,'.` f .64417 � / • ....a . o ,z `
Final Clean ut•
)
Pink Copy: SEH
Notes
n
r `
Number
Correctly
.Discha
Incorrectly
ed
Unknown
Total
Sump pumps
y� I
— _ " _ -
Foundation drains
Roof drains
)qt)D9
City ill lia R
Residential Sanitary Sewer Service
Compliance Inspection
Date (72/ 271 1C7 Time ! :J72
Name 7' 7 ,sue Disk #
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupa gnature
Compliance
i 10 foundation drain connection
r No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
$' No sump pump
Service Lateral Inspection Findings
0
o am
0f-Pm
Street Name
1
[Id
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
Record Number
Number of stacks t Entered S L at
Length of Service:
Yellow Copy: City of Eagan
._---
<V n'
Time a pm
Phone
j
= / Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor PipeJoints
Mineral Deposits
fr
Sag /Pipe Deflection
Damaged Pipe / /71-:id-1/ ,�- --
Transition L/ 1 / c�l ,'.` f .64417 � / • ....a . o ,z `
Final Clean ut•
)
Pink Copy: SEH