4823 Richard Lane - Inspection FormSump pumps
/
Foundation drains
Roof drains
_
=--,
City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date
J,` , C-) 1
i
Name
PID Number
House Number ` - j am ` r '
/„..;. � Street Name
Alternative Mailing Address
t f
Ownerlbccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
./t No sump pump
Tim
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Total
Disk #
Correctly
cp am
• fb pm
-LLJ
Number of stacks
Length of Service:.
Incorrectly
For information call 651 .470.2788
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 Discharged
Unknown
Record Number
[1 Time
Phone r. .. _ � % . - f
•l
Obstruction
Unable to push past
feet
Notes
•
Final Cleanout:
o am
O pm
Inspector Signature . , r?,! ��d J� /
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH