1487 Thomas Lane - Inspection FormCit al to an
� o
Residential Sanitary Sewer Service
Compliance Inspection
Date r`I 1i
� ~ 3
Time "° '° a
Name . Y7 3/ Disk #
PID Number
House Number
4" to 6 "Transition:
r
ry
I
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
z
5 ,.7 Street Name
Owner /Occupant Signature
BM
p
Alternative Mailing Address
fi
For information calk 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
Record Number
Time
Phone 7,
Obstruction
Unable to push past
feet
• O am
• O pm
Inspector Signature ;}
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral inspection Findings Number of stacks Entered S . at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH
Number Discharged
Note s
f
�' r r t .
l , f i
Total
Correctly
Incorrectly
Unknown
Sump pumps
' . e
� _: : n 3 ' a
.
Foundation drains
Roof drains
5
,
Cit al to an
� o
Residential Sanitary Sewer Service
Compliance Inspection
Date r`I 1i
� ~ 3
Time "° '° a
Name . Y7 3/ Disk #
PID Number
House Number
4" to 6 "Transition:
r
ry
I
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
z
5 ,.7 Street Name
Owner /Occupant Signature
BM
p
Alternative Mailing Address
fi
For information calk 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
Record Number
Time
Phone 7,
Obstruction
Unable to push past
feet
• O am
• O pm
Inspector Signature ;}
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral inspection Findings Number of stacks Entered S . at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH