4825 Eriks Blvd - Inspection FormCity of Era 3
Residential Sanitary Sewer Service
Compliance Inspection
Date fe i t
House Number
Time,
Disk #
PID Number
„Street Name
am
pm
Q7
1.
Record Number
Time
7-
O am
•
• O pm
ri
Alternative Mailing Address Phone r:�� . _- 24,
For information call 651.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer.
O Sump pump properly piped
No sump pump
2 -1 r.`( r
Owner /Occupant Signature
4" to 6" Transition:
White Copy: Property Owner
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
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L.at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
Inspector Signature i 1 14 /7 -
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Number
Discharged
Correctly
incorrectly Unknown
Sump pumps
'' j '
1 ( j '
i '°
/ iCk :.
Foundation drains
Roof drains
J ,
City of Era 3
Residential Sanitary Sewer Service
Compliance Inspection
Date fe i t
House Number
Time,
Disk #
PID Number
„Street Name
am
pm
Q7
1.
Record Number
Time
7-
O am
•
• O pm
ri
Alternative Mailing Address Phone r:�� . _- 24,
For information call 651.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer.
O Sump pump properly piped
No sump pump
2 -1 r.`( r
Owner /Occupant Signature
4" to 6" Transition:
White Copy: Property Owner
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
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L.at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
Inspector Signature i 1 14 /7 -
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH