4717 Covington Cir - Inspection FormCity of Emil
Residential Sanitary Sewer Service
Compliance Inspection
Date (l1 �' I )71
Name
rvl LS 1 P C Disk#
PID Number
House Number I Street Name
Alternative MailingAdddss
Owner /Occupar tSig
For information call 651.470.2788
Compliance
0 No foundation drain connection
b 'No roof drain connection
k°tl
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings Number of stacks Entered S. L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
White Copy: Pr operty Owner
Phone _ _.
Non - Compliance
O Clear water connections to
sanitary sewer
by
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
inspector Signature
Obstruction
Unable to push past
feet..
•
Final Cleanout:
0 a
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
!
.
- y 3'
- •,' ' �a
' ' V
L..
r
9
� ,. F
: .
7 ‹._
._- E ....
. 1
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
t
+
° r , � �3
Y > ;y'
d,
. . /
Foundation drains
`!
W
Roof drains
IIII
City of Emil
Residential Sanitary Sewer Service
Compliance Inspection
Date (l1 �' I )71
Name
rvl LS 1 P C Disk#
PID Number
House Number I Street Name
Alternative MailingAdddss
Owner /Occupar tSig
For information call 651.470.2788
Compliance
0 No foundation drain connection
b 'No roof drain connection
k°tl
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings Number of stacks Entered S. L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
White Copy: Pr operty Owner
Phone _ _.
Non - Compliance
O Clear water connections to
sanitary sewer
by
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
inspector Signature
Obstruction
Unable to push past
feet..
•
Final Cleanout:
0 a
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH