4740 Walden Dr - Inspection FormCity f Ca ap
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date F ./ / . .1
Name
('( °�e -:?)..fr 9 /Disk#
PID Number
Alternative Mailing Address
Service Lateral Inspection Findings
Compliance
O No foundation drain connection
No roof drain connection
0 ?Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to b" Transition:
White Copy: Property Owner
( -�
�,
am
Time eG • pm
Owner /Occupant Signature
House Number .'=t Street Name
Number of stacks
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
• o am
• o pm
Phone !��s5 �� 7 ,„'. )
Inspector Signature 7
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S•L•at
Roots
Poor PipeJoints
Final Cleanout:
Pink Copy: SEH
Nurnber
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
% `'
`tom
Foundation drains
Roof drains
/ 7-7
/%.,
City f Ca ap
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date F ./ / . .1
Name
('( °�e -:?)..fr 9 /Disk#
PID Number
Alternative Mailing Address
Service Lateral Inspection Findings
Compliance
O No foundation drain connection
No roof drain connection
0 ?Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to b" Transition:
White Copy: Property Owner
( -�
�,
am
Time eG • pm
Owner /Occupant Signature
House Number .'=t Street Name
Number of stacks
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
• o am
• o pm
Phone !��s5 �� 7 ,„'. )
Inspector Signature 7
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S•L•at
Roots
Poor PipeJoints
Final Cleanout:
Pink Copy: SEH