4392 Sandstone Dr - Inspection FormCity or Eapp
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name 77.
,/ , Disk #
PID Number
House Number
Alternative MailingAddress
Compliance
No foundation drain connection
No roof drain connection
0 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Q No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Ft. � Time / ,
- f
1 `, 11M:(
irerlOccupant Signature
am
Pm
Street Name
Phone
For information ca 651.470.2788
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
Ser vice L to I Inspection Findings umber of stacks
Roots t —_ ' ,
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Record Number
Time
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S L.at
Not s
am
•
• d pm
O Access to service
lateral needed
O inspection
refused
Final Cleanout:
f � 1
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
(,____,I
City or Eapp
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name 77.
,/ , Disk #
PID Number
House Number
Alternative MailingAddress
Compliance
No foundation drain connection
No roof drain connection
0 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Q No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Ft. � Time / ,
- f
1 `, 11M:(
irerlOccupant Signature
am
Pm
Street Name
Phone
For information ca 651.470.2788
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
Ser vice L to I Inspection Findings umber of stacks
Roots t —_ ' ,
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Record Number
Time
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S L.at
Not s
am
•
• d pm
O Access to service
lateral needed
O inspection
refused
Final Cleanout:
f � 1
Yellow Copy: City of Eagan Pink Copy: SEH