2069 Copper Lane - Inspection FormCity of salsa
Residential Sanitary Sewer Service
Compliance Inspection
Date /
Name Ai l / ] /4/0
PID Number
House Number ( { <:) Street Name
Alternative Mailing Address
/r.
Owner/Occupant Signature
For information call 651.47
o pliance
No foundation drain connection
11
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
No roof drain connection
Service Late al t�nsp ce tion Findings
Roots J
4" to 6" Transition:
White Copy: Property Owner
c—±,--)
Time- � • 1fi pm
Disk #
Non - Compliance
f ��
.1 ) - 7 2
Phone`
O Clear water connections to Unable to push past
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
t
Length of Service: •
i' C✓' j_ i i rte
Yellow Copy: City of Eagan
Record Number
am
Time `~ • _ pm
Obstruction
Inspector Signature
feet
Number of stacks I Entered S L. at
No Access
O No one in
rt.
Cleanout:
O Access to service
lateral needed
O Inspection
refused
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe /I
'Transition
1�
Pink Copy: SEH
Total
Notes
.,,'
-..
Number.
Discharged
.
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City of salsa
Residential Sanitary Sewer Service
Compliance Inspection
Date /
Name Ai l / ] /4/0
PID Number
House Number ( { <:) Street Name
Alternative Mailing Address
/r.
Owner/Occupant Signature
For information call 651.47
o pliance
No foundation drain connection
11
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
No roof drain connection
Service Late al t�nsp ce tion Findings
Roots J
4" to 6" Transition:
White Copy: Property Owner
c—±,--)
Time- � • 1fi pm
Disk #
Non - Compliance
f ��
.1 ) - 7 2
Phone`
O Clear water connections to Unable to push past
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
t
Length of Service: •
i' C✓' j_ i i rte
Yellow Copy: City of Eagan
Record Number
am
Time `~ • _ pm
Obstruction
Inspector Signature
feet
Number of stacks I Entered S L. at
No Access
O No one in
rt.
Cleanout:
O Access to service
lateral needed
O Inspection
refused
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe /I
'Transition
1�
Pink Copy: SEH