1408 Rebecca Lane - Inspection Form1 City of Fla an
Residential Sanitary Sewer Service
Compliance Inspection
Date . / f / / (/./
7
Time - •
Name ij Disk#
PID Number
House Number 1 ^ I k Street Name
Alternative Mailing Address
rr
Owner /Occupant Signat f
Compliance
O No foundation drain connection
C�
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 " Transition:
White Copy: Property Owner
Non - Compliance
O
O
O
O
O
am
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
-m
Yellow Copy: City of Eagan
Record Number ` ")
Phone 7
Time
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S L at
Final Cleanout:
O am
•
O pm
No Access
O No one in
•
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 Discharged
Noes f
=„ = ,_ ), ` G_
r.:- ":,c'.. cam/' 41 , • , f G � . , / ."
Total
Correctly
Incorrectly
Unknown
Sump pumps
-.^._ ,,.—
' i'
' , rs,
Foundation drains
Roof drains
1 City of Fla an
Residential Sanitary Sewer Service
Compliance Inspection
Date . / f / / (/./
7
Time - •
Name ij Disk#
PID Number
House Number 1 ^ I k Street Name
Alternative Mailing Address
rr
Owner /Occupant Signat f
Compliance
O No foundation drain connection
C�
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 " Transition:
White Copy: Property Owner
Non - Compliance
O
O
O
O
O
am
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
-m
Yellow Copy: City of Eagan
Record Number ` ")
Phone 7
Time
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S L at
Final Cleanout:
O am
•
O pm
No Access
O No one in
•
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH