4834 Eriks Blvd - Inspection Form4_ City of Ea a
Residential Sanitary Sewer Service
Compliance Inspection
Date f , /.
/ f J 1 1 !!
r , —
Name
Alternative Mailing Address
4" to 6" Tr ansition:
White Copy: Propel ty Owner
Time •
Disk #
' OwriOccupant Signature
Compliance
O No foundation drain connection
/ O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
am
a pm
P1D Number
House Number ) ®.t . Street Name
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
Number of stacks
Roots
MENEM
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
•
•
Phone ?�
Inspector Signature , _ -- � i 7
75
1 .�
For information call 651.470.2788
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Entered S,L,at
Poor Pipe Joints
Final Cleanout:
p am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SE H
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
( "
Foundation drains
Roof drains
4— r /-
4_ City of Ea a
Residential Sanitary Sewer Service
Compliance Inspection
Date f , /.
/ f J 1 1 !!
r , —
Name
Alternative Mailing Address
4" to 6" Tr ansition:
White Copy: Propel ty Owner
Time •
Disk #
' OwriOccupant Signature
Compliance
O No foundation drain connection
/ O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
am
a pm
P1D Number
House Number ) ®.t . Street Name
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
Number of stacks
Roots
MENEM
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
•
•
Phone ?�
Inspector Signature , _ -- � i 7
75
1 .�
For information call 651.470.2788
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Entered S,L,at
Poor Pipe Joints
Final Cleanout:
p am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SE H