4878 Richard Lane - Inspection Formilk •
City 01 Eap,ao
Residential Sanitary Sewer Service
Compliance Inspection
?
Date /
Name
Disk
PID Number
House Number ("S Street Name
Owner/6ccupant Signature
White Copy: Property Owner
i • am
Time 1
• Pm
.0.1V
Yellow Copy: City of Eagan
Record Number / „
Alternative Mailing Address Phone
• am
Time • 0 'Prin
inspector Signature
\ » •
Pink Copy: SEH
For information call 651.470.2788
Compliance
Non-Compliance
Obstruction
No Access
0 No foundation drain connection
No roof dram connection
A i
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
0 No sump pump
0 Clear water connections to
sanitary sewer
0 Service lateral defects
0 Defective manholes
0 Sump pump connected to sanitary
sewer.
0 Flexible sump pump piping
Unable to push past
feet
0 No one in
0 Access to service
lateral needed
0 Inspection
refused
Service Lateral inspection Findings Number of stacks
Roots
Entered St at
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition: Length of Service: Final Cleanout:
Total
Notes
1 ----, ---?....
y)
,,,
.,-
C.., / 1 14 / 1
i
..,-:), i -;.-.:4
■--/ -± ..'"--'..!;:? ' ' 11\
1
r
Number
Discharged
Correctly
Incor•r•ectly Unknown
Sump pumps
1
4 1--
/ .
----- ,:,.._,-,_,-...
.
).,---1....---^,-,,--,
' f
•
•a U)
,3 i 7
i 7 .-- ,
Foundation drains
i , .,
Roof drains
„--
, )
..„
ilk •
City 01 Eap,ao
Residential Sanitary Sewer Service
Compliance Inspection
?
Date /
Name
Disk
PID Number
House Number ("S Street Name
Owner/6ccupant Signature
White Copy: Property Owner
i • am
Time 1
• Pm
.0.1V
Yellow Copy: City of Eagan
Record Number / „
Alternative Mailing Address Phone
• am
Time • 0 'Prin
inspector Signature
\ » •
Pink Copy: SEH