4806 Shevlin Ct - Inspection FormCity of Ego
Residential Sanitary Sewer Service
Compliance Inspection
},9 .
Date / �1 d / i /
Nam s 3 I ) - ' Disk #
1 ---
PID Number
House Number -' - (..% )Street Name
Alternative 11 dr•ess Phone
/ //I
For information call 651.470.2788
Compliance
O No foundation drain connection 0
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump 0
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
Owner /Occupant Signature
Pm
Non - Compliance
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
1
Time
Obstruction
Unable to push past
feet
Entered S. L at
Inspector Signature
Final Cleanout:
o am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
C3 Inspection
refused
Roots
Poor
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Di
Incorrectly
Unknown
Notes
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Total
Sump pumps
. .
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f 3 T'A
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Foundation drains
Roof drains
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11.111
City of Ego
Residential Sanitary Sewer Service
Compliance Inspection
},9 .
Date / �1 d / i /
Nam s 3 I ) - ' Disk #
1 ---
PID Number
House Number -' - (..% )Street Name
Alternative 11 dr•ess Phone
/ //I
For information call 651.470.2788
Compliance
O No foundation drain connection 0
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump 0
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
Owner /Occupant Signature
Pm
Non - Compliance
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
1
Time
Obstruction
Unable to push past
feet
Entered S. L at
Inspector Signature
Final Cleanout:
o am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
C3 Inspection
refused
Roots
Poor
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH