4856 Windsor Ct - Inspection Form41*
lit of Eagn
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
•
4" to 6"Transition:
1
RD Number
House Number _L._ Street Name
• ,
• /
(
White Copy: Pi opet ty Owner
Compliance
O No foundation drain connection
No roof drain connection
,r p Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
am
Time ,;iPm
Disk #
Owner/Occupant Signature
42,
Length of Service:
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
Yellow Copy: City of Eagan
Record Number 1—
Time
Obstruction
Unable to push past
feet
Final Cleanout:
,
•
• o pm
Alternative Mailing Address Phone —
-
Inspector Signature )
\
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipefoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
• •
Number
Correctly
Discharged
incorrectly Unknown
Notes
- -,
' ,•',' •,- 1
----/-'
en
, ) 1
i .,-----); -_--- T/i .1-..,,,,-.7,...„....),„...,1
.....,' - ,--_, /
Total
Sump pumps
,•/
l ,/ ---,
Foundation drains
,i
..,..:.
Roof drains
,)?
41*
lit of Eagn
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
•
4" to 6"Transition:
1
RD Number
House Number _L._ Street Name
• ,
• /
(
White Copy: Pi opet ty Owner
Compliance
O No foundation drain connection
No roof drain connection
,r p Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
am
Time ,;iPm
Disk #
Owner/Occupant Signature
42,
Length of Service:
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
Yellow Copy: City of Eagan
Record Number 1—
Time
Obstruction
Unable to push past
feet
Final Cleanout:
,
•
• o pm
Alternative Mailing Address Phone —
-
Inspector Signature )
\
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipefoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
• •