1476 Thomas Lane - Inspection FormCity of hp
Residential Sanitary Sewer Service
Compliance Inspection
/�. 7 !1 i../
Date l7 1. i .' / /
Name
PID Number
House Number ! ' /� Street Name
Alternative Mailing A dress
OwrierlOccupant Signature
Compliance
O No foundation drain connection
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
} S
.2 am
Time !` • !O pm
Disk #
J-
Record Number /
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
Phone
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
o am
•
• o pm
inspector Signature 4 ) //y
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
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-
r �..
-- :1 — �� / f`'
7
Total
Sump pumps
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- )
i'
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:,,r
Foundation drains
1111111.11
Roof drains
i _)
City of hp
Residential Sanitary Sewer Service
Compliance Inspection
/�. 7 !1 i../
Date l7 1. i .' / /
Name
PID Number
House Number ! ' /� Street Name
Alternative Mailing A dress
OwrierlOccupant Signature
Compliance
O No foundation drain connection
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
} S
.2 am
Time !` • !O pm
Disk #
J-
Record Number /
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
Phone
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
o am
•
• o pm
inspector Signature 4 ) //y
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH