4765 Eriks Blvd - Inspection FormCity of Ea all
Residential Sanitary Sewer Service
Compliance Inspection
) 1
Date 4' 1 l
'.r
7/
p ;am
Time = ? pm
Name . ., 3 Jr-7,'t7t ' r3I Disk #
PID Number
House Number f " 3 Street Name
i
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
o Sump pump properly piped
'O No sump pump
4" to 6 "Transition:
White Copy: Pt opei ty Owner
Owner /Occupant Signature
Length of Service:
Q7
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
0 am
•
Time • O pm
Alternative Mailing Address Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
_ feet
Final Cleanout:
No Access
O No one in
O Inspection
refused
O Access to service
lateral needed
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
s _
Number
Discharged
Correctly
Incorrectly
Unknown
i ce)
Sump pumps
ty _
/ �
! ..
1 -�
Foundation drains
Roof drains
1 1
City of Ea all
Residential Sanitary Sewer Service
Compliance Inspection
) 1
Date 4' 1 l
'.r
7/
p ;am
Time = ? pm
Name . ., 3 Jr-7,'t7t ' r3I Disk #
PID Number
House Number f " 3 Street Name
i
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
o Sump pump properly piped
'O No sump pump
4" to 6 "Transition:
White Copy: Pt opei ty Owner
Owner /Occupant Signature
Length of Service:
Q7
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
0 am
•
Time • O pm
Alternative Mailing Address Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
_ feet
Final Cleanout:
No Access
O No one in
O Inspection
refused
O Access to service
lateral needed
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH