4876 Richard Lane - Inspection FormCity of to an
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number
i
Compliance
O, No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
/'
/
4" to 6 "Transition:
/Si Disk#
White Copy: Property Ownei
Time
Owner/Occupant Signature
' Qam
• Q Pm
,i7 Street Name
1
- CD -LL
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
Record Number �
Alternative Mailing Address Phone `- -, 1
Notes
0 a
Time • O pm
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 Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: Final Cleanout:
nspector Signature ] ,-, , vJ n
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
r
Foundation drains
Roof drains
,,14--
City of to an
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number
i
Compliance
O, No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
/'
/
4" to 6 "Transition:
/Si Disk#
White Copy: Property Ownei
Time
Owner/Occupant Signature
' Qam
• Q Pm
,i7 Street Name
1
- CD -LL
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
Record Number �
Alternative Mailing Address Phone `- -, 1
Notes
0 a
Time • O pm
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 Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: Final Cleanout:
nspector Signature ] ,-, , vJ n
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH