3697 Windtree Dr - Inspection Form(Residential Sanitary Sewer Service
{ I I PAP] Compliance Inspection
Date r / // / ,/ //
Time
Name /62/frthiAl Disk #
PID Number
House Number Street Name
Alternative ailing Address
-t'
4" to 6 "Transition:
White Copy: Property Owner
Owner /Occupant Signature
Compliance
LT "No foundation drain connection
No roof drain connection
Sump pit not connected to
, sanitary sewer
0 Sump pump properly piped
■No sump pump
o am
( g
//1,4
1
For information call 651 2788
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
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection qq(-' !
Damaged Pipe
Transition
(
Yellow Copy: City of Eagan
X11
Record Number
Length of Service:
Time
/1 372 / /f - x
J 'Inspector Signature
Notes
Obstruction
Unable to push past
feet
Entered S L at c�.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Clean
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
_
T a
.__. __..
_
Foundation drains
-- ---'—
Roof drains
(Residential Sanitary Sewer Service
{ I I PAP] Compliance Inspection
Date r / // / ,/ //
Time
Name /62/frthiAl Disk #
PID Number
House Number Street Name
Alternative ailing Address
-t'
4" to 6 "Transition:
White Copy: Property Owner
Owner /Occupant Signature
Compliance
LT "No foundation drain connection
No roof drain connection
Sump pit not connected to
, sanitary sewer
0 Sump pump properly piped
■No sump pump
o am
( g
//1,4
1
For information call 651 2788
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
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection qq(-' !
Damaged Pipe
Transition
(
Yellow Copy: City of Eagan
X11
Record Number
Length of Service:
Time
/1 372 / /f - x
J 'Inspector Signature
Notes
Obstruction
Unable to push past
feet
Entered S L at c�.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Clean
Pink Copy: SEH