4747 Westminster Cir - Inspection FormCity of Ea go
Residential Sanitary Sewer Service
Compliance Inspection
Date 2
Name
k
PID Number
House Number _ : 7Street Name
Compliance
O No foundation drain connection
ti
c No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
/0/ Disk #
V o am
Time
� pm
Owner /Occupant Signature
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
Length of Service:
Record Number
Notes
Time
3
Alternative Mailing Address Phone /. 2 7) - _ )(i?
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor PipeJoints
Final Cleanout:
O am
•
• Opm
inspector Signature /4/
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r
;,../,,,,
Yellow Copy: City of Eagan Pink Copy: SEH
r:hy
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
r l:
/ 3
C -71 3
Foundation drains
al
/i
,7
111
Roof drains
City of Ea go
Residential Sanitary Sewer Service
Compliance Inspection
Date 2
Name
k
PID Number
House Number _ : 7Street Name
Compliance
O No foundation drain connection
ti
c No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
/0/ Disk #
V o am
Time
� pm
Owner /Occupant Signature
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
Length of Service:
Record Number
Notes
Time
3
Alternative Mailing Address Phone /. 2 7) - _ )(i?
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor PipeJoints
Final Cleanout:
O am
•
• Opm
inspector Signature /4/
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r
;,../,,,,
Yellow Copy: City of Eagan Pink Copy: SEH
r:hy