4289 Rahn Rd - Inspection FormT City of laiaa
Residential Sanitary Sewer Service
Compliance Inspection
/ Time
4,. isk#
MD Number gym.
Date
Name
House Number
L7 , 7 Street Name
OwnerlOccupant Signature
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
0� Sump pump properly piped
Q No sump pump
fI
Service lateral inspection Findings
r7 J
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
O
O
0
0
0
/1
am
pm
Non - Compliance
Alternative MailingAddress
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer.
Flexible sump pump piping
Number of stacks
r`1
Length of Service:
Yellow Copy: City of Eagan
Record Number
rfj7)me
Phone / J
1
2
Inspector Signature
or information call 651:470:2788
Obstruction
Unable to push past
feet
Final Cleanout:
• am
® pm
Entered S L at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Notes
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
--
Roof drains
0
I' ) -SiO 779
T City of laiaa
Residential Sanitary Sewer Service
Compliance Inspection
/ Time
4,. isk#
MD Number gym.
Date
Name
House Number
L7 , 7 Street Name
OwnerlOccupant Signature
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
0� Sump pump properly piped
Q No sump pump
fI
Service lateral inspection Findings
r7 J
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
O
O
0
0
0
/1
am
pm
Non - Compliance
Alternative MailingAddress
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer.
Flexible sump pump piping
Number of stacks
r`1
Length of Service:
Yellow Copy: City of Eagan
Record Number
rfj7)me
Phone / J
1
2
Inspector Signature
or information call 651:470:2788
Obstruction
Unable to push past
feet
Final Cleanout:
• am
® pm
Entered S L at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH