2069 Jade Lane - Inspection FormCity of taR,ao
Residential Sanitary Sewer Service
Compliance Inspection
Date r,` .7 / ./7
House Number
4" to 5" Transition:
i .7
f - ) :
Name Disk #
PID Number
Alternative Mailing Address
>!
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
White Copy: Property Owner
Street Name
OwnerlOccupant Signature
For. information cal
651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
No sump pump 0 Flexible sump pump piping
Service Lateral Inspection Findings Numb l of stacks Entered S L at
--- -�
Roots i` �- - r - f } �: ==
Poor Pipejoints
Mineral Deposits
`S %/Pipe Deflection
Damaged Pipe I
1
Transition L , : r ' ( 7 /7 ' 1 '' /
Time
2
a V r ; am
pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Length of Service:
Yellow Copy: City of Eagan
Record Number
. • 0, am
®-
Time • pm
7•
Phone ,<
Inspector Signature
Obstruction
Unable to push past
feet
c __7
L
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
a
Final Cleanout: f /-
Pink Copy: SEH
Number
Correctly
Discharged
Notes
, - °='
f- -' /� ' rte -` ' ' ; '— ` `— 'L ,
/ '
r i
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
✓
Roof drains
}
City of taR,ao
Residential Sanitary Sewer Service
Compliance Inspection
Date r,` .7 / ./7
House Number
4" to 5" Transition:
i .7
f - ) :
Name Disk #
PID Number
Alternative Mailing Address
>!
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
White Copy: Property Owner
Street Name
OwnerlOccupant Signature
For. information cal
651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
No sump pump 0 Flexible sump pump piping
Service Lateral Inspection Findings Numb l of stacks Entered S L at
--- -�
Roots i` �- - r - f } �: ==
Poor Pipejoints
Mineral Deposits
`S %/Pipe Deflection
Damaged Pipe I
1
Transition L , : r ' ( 7 /7 ' 1 '' /
Time
2
a V r ; am
pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Length of Service:
Yellow Copy: City of Eagan
Record Number
. • 0, am
®-
Time • pm
7•
Phone ,<
Inspector Signature
Obstruction
Unable to push past
feet
c __7
L
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
a
Final Cleanout: f /-
Pink Copy: SEH