1429 Rebecca Lane - Inspection Form4 .0 111. Ry of Eq3
Residential Sanitary Sewer Service
Compliance Inspection
•
) -
Date
Name
/7
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
4" to 6" Transition:
/)
White Copy: Propel ty Owner
Time •
Owner/Ciccupant Signature
am
pm
X
Record Number
Time
PID Number
(7) )
House Number ) 2.-- ) - 7.0. 4 . 1: -. 2 ` - '1 Street Name 7
Alternative Mailing Addr ess Phone4 . 4 ))
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
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet.
Number of stacks Entered S. .L at
•
•
Length of Service: Final Cleanout:
Notes
o am
0 pm
'7
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
r' _
/)
, )
- 21
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
.4
/
)_.
L.,r
--, •-•,
- '5 .- /
/ i
,,zi) ) .4:
'-' T
./1 ,....i---
/ „, , L.- i
•' I
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Foundation drains
.7
i
,
Roof drains
/
,
V
4 .0 111. Ry of Eq3
Residential Sanitary Sewer Service
Compliance Inspection
•
) -
Date
Name
/7
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
4" to 6" Transition:
/)
White Copy: Propel ty Owner
Time •
Owner/Ciccupant Signature
am
pm
X
Record Number
Time
PID Number
(7) )
House Number ) 2.-- ) - 7.0. 4 . 1: -. 2 ` - '1 Street Name 7
Alternative Mailing Addr ess Phone4 . 4 ))
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
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet.
Number of stacks Entered S. .L at
•
•
Length of Service: Final Cleanout:
Notes
o am
0 pm
'7
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
r' _
/)
, )
- 21
Yellow Copy: City of Eagan Pink Copy: SEH