3615 Great Oaks Cir - Inspection FormSump pumps
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Foundation drains
Roof drains
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li City of bp
n
Residential Sanitary Sewer Service
Compliance Inspection
Date !i :l 1 / 1 )(1
<
lda 7 - a--2 3 Disk #
PID Number )`
House Number /Lc Street Name
Name
Alternative Mailing Address
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
i
Transition -
4" to 6" Transition:
Own erlOccupant Signature
For information call 651.470.2788
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
/l /
White Copy: Proper ty Owner
Time .
am
pm
1
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
Numper of stacks Entered S L at
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
Notes
Time 2
Phone._`: ,/�•�,
ogr
Inspector Signature
Obstruction
Unable to push past
feet
6- o . am
• a pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
" r, aC .= 1 )j ;- n
i
} 1 1 1✓
Len of Service: l / t - Final Cleanout: �--✓,
fir__.
Yellow Copy: City of Eagan Pink Copy: SEH
City o1' Fa as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number !r� .J m Street Name
Alternative Mailing Address
For information call 651:470:2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor P,pef oin
t -- i — c, ,-----, e ▪ <---. :-.), ,------ ,,,
d eflection ... °» " "` - -, „ 4,, r - --� - #
Mineralee sits
Sag /Pip
Dam ged'pipe
T nsition
4" to 6 "Transition:
l
White Copy: Property Owner
• � 0 am
Time
• pm
Disk #
OwnerlOccupant Signature
j-j_j-[j_]
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
Number of stacks
Record Number 7
Time
Obstruction
Unable to push past
feet
Length of Service:
Yellow Copy: City of Eagan
• O am
• O pm
— . Z:::1(1
Phone �� 7- ` .,,
Inspector Signature
Final Cleanout:
No Access
0 No one in
Access to service
lar al
0 Irrspecti n '
refused
Entered 5 -L, at
j.5
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Notes
Total
Unknown
Sump pumps
Foundation drains
Roof drains
City o1' Fa as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number !r� .J m Street Name
Alternative Mailing Address
For information call 651:470:2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor P,pef oin
t -- i — c, ,-----, e ▪ <---. :-.), ,------ ,,,
d eflection ... °» " "` - -, „ 4,, r - --� - #
Mineralee sits
Sag /Pip
Dam ged'pipe
T nsition
4" to 6 "Transition:
l
White Copy: Property Owner
• � 0 am
Time
• pm
Disk #
OwnerlOccupant Signature
j-j_j-[j_]
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
Number of stacks
Record Number 7
Time
Obstruction
Unable to push past
feet
Length of Service:
Yellow Copy: City of Eagan
• O am
• O pm
— . Z:::1(1
Phone �� 7- ` .,,
Inspector Signature
Final Cleanout:
No Access
0 No one in
Access to service
lar al
0 Irrspecti n '
refused
Entered 5 -L, at
j.5
Pink Copy: SEH
r' City of F;a n
Residential Sanitary Sewer Service
Compliance Inspection
Dated
Name ..! ;°° i/i t--"` #
PID Number
House Numbed Street Name _-1_, i
Alternative Mailing Address
Compliance
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
v' .i t ter.
OwnerlOccupant Signature
O No foundation drain connection 0 Clear water connections to
O No roof drain connection sanitary sewer
O Service lateral defects
Service Lateral Inspection Findings
Poor R Join
Mineralee sits
Sag /Pip eflection
Dam ged \ipe
T nsition
4" to 6" Transition:
White Copy: Proper ty Owner
I • "7 3
Time , r. : pm
Non - Compliance
Length of Service:
[1�
Phone
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
Record Number
Notes
Time
Inspector Signature
Obstruction
Unable to push past
feet
For information .call 651
Entered S L at
Roots
f _...,_ t � dd
) /
Final Cleanout:
• o am
• O pm
No Access
O No one in
r
Access to service
f la alneedeed
O Inp'etdn�
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
r' City of F;a n
Residential Sanitary Sewer Service
Compliance Inspection
Dated
Name ..! ;°° i/i t--"` #
PID Number
House Numbed Street Name _-1_, i
Alternative Mailing Address
Compliance
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
v' .i t ter.
OwnerlOccupant Signature
O No foundation drain connection 0 Clear water connections to
O No roof drain connection sanitary sewer
O Service lateral defects
Service Lateral Inspection Findings
Poor R Join
Mineralee sits
Sag /Pip eflection
Dam ged \ipe
T nsition
4" to 6" Transition:
White Copy: Proper ty Owner
I • "7 3
Time , r. : pm
Non - Compliance
Length of Service:
[1�
Phone
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
Record Number
Notes
Time
Inspector Signature
Obstruction
Unable to push past
feet
For information .call 651
Entered S L at
Roots
f _...,_ t � dd
) /
Final Cleanout:
• o am
• O pm
No Access
O No one in
r
Access to service
f la alneedeed
O Inp'etdn�
refused
Yellow Copy: City of Eagan Pink Copy: SEH