1492 Thomas Lane - Inspection Formr
Datef I
Name
PID Number
4101i
City 1 Ca an
Y �
Residential Sanitary Sewer Service
Compliance inspection
House Number t-
4" to 6 "Transition:
White Copy: Property Owner
D #
s' ")
Street Name
} ` 1-.di' p am
Time pi
Owner /Occupant Signature
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
Service Lateral Inspection Findings
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Time
Alternative Mailing Address Phone —)
Obstruction
Unable to push past
feet
Number of stacks Entered S at
Final Cleanout:
O am
•
• O pm
I
No Access
O No one in
Inspector Signature
For information call 651.4701788
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
`+ . " "� � i " '
, i"
7. ) " -t -
-7.- . '711 - ,�°'. .."
Total
Sump pumps
)
V
Foundation drains
=
Roof drains
r
Datef I
Name
PID Number
4101i
City 1 Ca an
Y �
Residential Sanitary Sewer Service
Compliance inspection
House Number t-
4" to 6 "Transition:
White Copy: Property Owner
D #
s' ")
Street Name
} ` 1-.di' p am
Time pi
Owner /Occupant Signature
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
Service Lateral Inspection Findings
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Time
Alternative Mailing Address Phone —)
Obstruction
Unable to push past
feet
Number of stacks Entered S at
Final Cleanout:
O am
•
• O pm
I
No Access
O No one in
Inspector Signature
For information call 651.4701788
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH