4610 Kingsbury Dr - Inspection Form4 City of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name"71
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
'O` No sump pump
4" to 6 "Transition:
White Copy: Property Owner
1
j C✓ 0 a
:
Time •
Disk #
pm
f✓ Owner /Occupant Signature // /
Non - Compliance
PID Number /
House Number () / % Street Name /)t / �f `
Alternative Mailing Address Phone -7) ,.2_ "
For information call 651.470.2788
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S..L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
0 am
Time • o pm
•
Obstruction
Inspector Signature \ �
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Notes
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Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
c i
4 City of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name"71
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
'O` No sump pump
4" to 6 "Transition:
White Copy: Property Owner
1
j C✓ 0 a
:
Time •
Disk #
pm
f✓ Owner /Occupant Signature // /
Non - Compliance
PID Number /
House Number () / % Street Name /)t / �f `
Alternative Mailing Address Phone -7) ,.2_ "
For information call 651.470.2788
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S..L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
0 am
Time • o pm
•
Obstruction
Inspector Signature \ �
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH