1428 Rebecca Lane - Inspection FormSump pumps
�. ,,,.,�
- r-;
1
/1( 1:77 � `7''
/
Foundation drains
Roof drains
-
41. My of lia a
Residential Sanitary Sewer Service
Compliance Inspection
99 r' 01 am
Date /� �'' 1 1/ i Time • yj pm
Name __ ) r��f t 3 f ,Disk#
PID Number
House Number A I— Street Name
Alternative Mailing Address Phone
b.
v
No roof drain connection
4" to 6" Transition:
White Copy: Pr operty Owner
Owner/Occupant Signature
-C�
Total Correctly Incorrectly Unknown
Compliance Non — Compliance
O No foundation drain connection 0 Clear water connections to
sanitary sewer
O Service lateral defects
Y Sump pit not connected to
0 Defective manholes
sanitary sewer
O Sump pump connected to sanitary
O Sump pump properly piped sewer
O No sump pump 0 Flexible sump pump piping
Number Discharged
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Length of Service: Final Cleanout:
• p am
• 0 pm
}
Inspector Signature ° .:
For information call 651.470.2788
No Access
O No one in
Notes
I l / -_.
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