1465 Thomas Lane - Inspection FormCity of Fa an
Residential Sanitary Sewer Service
Compliance Inspection
Date ;`Fit )))/ l
Name ) j/ Disk #
PID Number
House Number ) _t s Street Name
Transition
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
4" to 6 "Transition:
White Copy: Property Owner
Time !i_J•
OwnerlOcal!ant S
am
pm
aMINIs
Alternative Mailing Address Phone () .y )
For information call 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
Service Lateral Inspection Findings Number of stacks Entered S L.
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
J
Length of Service:
Yellow Copy: City of Eagan
—
Record Number
Time
Obstruction
Unable to push past
feet .
o am
•
• o pm
inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
4 Inspection
refused
Pink Copy: SEH
Number
. Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
t� _
,�
t
Foundation drains
/ (---'
Li
.
Roof drains
City of Fa an
Residential Sanitary Sewer Service
Compliance Inspection
Date ;`Fit )))/ l
Name ) j/ Disk #
PID Number
House Number ) _t s Street Name
Transition
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
4" to 6 "Transition:
White Copy: Property Owner
Time !i_J•
OwnerlOcal!ant S
am
pm
aMINIs
Alternative Mailing Address Phone () .y )
For information call 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
Service Lateral Inspection Findings Number of stacks Entered S L.
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
J
Length of Service:
Yellow Copy: City of Eagan
—
Record Number
Time
Obstruction
Unable to push past
feet .
o am
•
• o pm
inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
4 Inspection
refused
Pink Copy: SEH