1478 Thomas Lane - Inspection Form1 1.0 1 City of Ca an
Y �
Residential Sanitary Sewer Service
Compliance inspection
Date : `� � 1 /
4" to b" Transition:
Time w,_T; •
Owner /Occupant lgnature
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
White Copy: Proper ty Owner
Name )A. ;!. Disk #
err ..'�
PID Number
am
pm
House Number ) 4 ,/ _Street Name
Alternative Mailing Address Phone .'r. - ::� ) LL 4 1-
For information call 651.470.2788
Non- Compliancq
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 at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
•
•
0 a
O pm
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged Noted _ _
Incorrectly Unknown '- °''� ' - ' , ! '_ �
Total
Sump pumps
�a�
1 173 a
C _- %;'�y,!, °" i , t_
Foundation drains
1
f 4" 9 �
- M = 7I �
Roof drains
1 1.0 1 City of Ca an
Y �
Residential Sanitary Sewer Service
Compliance inspection
Date : `� � 1 /
4" to b" Transition:
Time w,_T; •
Owner /Occupant lgnature
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
White Copy: Proper ty Owner
Name )A. ;!. Disk #
err ..'�
PID Number
am
pm
House Number ) 4 ,/ _Street Name
Alternative Mailing Address Phone .'r. - ::� ) LL 4 1-
For information call 651.470.2788
Non- Compliancq
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 at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
•
•
0 a
O pm
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH