1420 Rebecca Lane - Inspection Form4 City IA Rap
Residential Sanitary Sewer Service
Compliance Inspection
Date f ) / ,/
Name
4" to 6" Transition:
RD Number
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump pump properly piped
o sump pump
White Copy: P3' oper ty Owner
_2/2 Varn
Time ir -6 pm
rl 0 ccu p a n (Si g n au, re
LL
Service Lateral Inspection Findings Number of stacks Entered S L at
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:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Final Cleanout:
o am
•
• 0 um
f- -----
House Number ) 2 - , -
• ,' Street Name
7 --."'" ) 1)
,_.-- •,--", s , •
Alternative Mailing Address Phone /---., IT ) -- ,,i_...)-- 1 --7,11 - ) V.-
---- ,
..-
-- .
"'-
inspector Signature )
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
, ,-.? ,)..„-., c - „i-
, i
- -,-.) .----- -----,, , i , / 1
,,'"'' ' f '
(-- -,.-L ----..- .----
1 e'f' .1 en ; /
i 171 ).—F-: , ,,e !... - :,), , ,,,:77--- .. 4 .---
: I
Total
Sump pumps
/I ,
I / -
..:::,-) i f ;-.;
,......... 7 ..„ -,-- -)
.(...---' I ' '-
r"..'
/4 1 -,
, -• '
7 (--.>---
Foundation drains
1 .
Roof drains
-----,
7 :::---,
4 City IA Rap
Residential Sanitary Sewer Service
Compliance Inspection
Date f ) / ,/
Name
4" to 6" Transition:
RD Number
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump pump properly piped
o sump pump
White Copy: P3' oper ty Owner
_2/2 Varn
Time ir -6 pm
rl 0 ccu p a n (Si g n au, re
LL
Service Lateral Inspection Findings Number of stacks Entered S L at
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:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Final Cleanout:
o am
•
• 0 um
f- -----
House Number ) 2 - , -
• ,' Street Name
7 --."'" ) 1)
,_.-- •,--", s , •
Alternative Mailing Address Phone /---., IT ) -- ,,i_...)-- 1 --7,11 - ) V.-
---- ,
..-
-- .
"'-
inspector Signature )
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH