4561 Lake Park Dr - Inspection Form4. or hapa
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
} •
/0 Time • o pm
am
:.7
)//-) Disk # I T
PID Number
House Number ) Street Name
Alternative Mailing Address
f` p ;t
f; . - " - � �
1 Own e v rl0ccupannt r Signature
Compliance
0 No foundation drain connection
} No roof drain connection
i
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
4" to 6" Transition:
White Copy: Property Owner
17l -Fl
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
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Record Number �, r
Phone / t
For information call 651.470.2788
Obstruction
Unable to push past
feet.
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Length of Service: Final Cleanout:
Notes
Time
Inspector Signature
• O am
• Opm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/f r
r
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
,/
—4--
Foundation drains
MI
Roof drains
]i
/ 1,
4. or hapa
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
} •
/0 Time • o pm
am
:.7
)//-) Disk # I T
PID Number
House Number ) Street Name
Alternative Mailing Address
f` p ;t
f; . - " - � �
1 Own e v rl0ccupannt r Signature
Compliance
0 No foundation drain connection
} No roof drain connection
i
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
4" to 6" Transition:
White Copy: Property Owner
17l -Fl
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
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Record Number �, r
Phone / t
For information call 651.470.2788
Obstruction
Unable to push past
feet.
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Length of Service: Final Cleanout:
Notes
Time
Inspector Signature
• O am
• Opm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/f r
r
Yellow Copy: City of Eagan Pink Copy: SEH