3638 Windtree Dr - Inspection FormLay of ha sp
Residential Sanitary Sewer Service
Compliance Inspection
Date 6c// / /y
: /Z
Name r �-f�I
PID Number
House Number Name
Alternative Mailing Address
Mineral Deposits
Sag /Pipe Deflection
White Copy: Property Owner
Time ( 7 • CIO l prn
Disk #
OwnerlOccu pan) Signature
Compliance
cY No foundation drain connection
No roof drain connection
b Sump pit not connected to
sanitary sewer
O Sump pump properly piped
c No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints y�ro
Damaged Pipe
Transition . on / ., ( } iJ
4" to 6" Transition: \ g
Length of Service:
1T7
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
Record Number
i`
For information call 651.470.2788
Number of stacks / Entered 5,L at . '
i
Phony t 17 ) iat ��
Obstruction
Unable to push past
feet
Notes
or am
Time
• ' O Pm
�-
Inspector Signature
ar /f / esr
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
/ 2:
t
Yellow Copy: City of Eagan Pink Copy: SEH
v
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
®
w.- .e...m._ -.
Foundation drains
i %'
W
_ ._
w _
Roof drains
r �Z w
'-•��' �=
°° " s +v- ..m.w ..
Ell
Lay of ha sp
Residential Sanitary Sewer Service
Compliance Inspection
Date 6c// / /y
: /Z
Name r �-f�I
PID Number
House Number Name
Alternative Mailing Address
Mineral Deposits
Sag /Pipe Deflection
White Copy: Property Owner
Time ( 7 • CIO l prn
Disk #
OwnerlOccu pan) Signature
Compliance
cY No foundation drain connection
No roof drain connection
b Sump pit not connected to
sanitary sewer
O Sump pump properly piped
c No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints y�ro
Damaged Pipe
Transition . on / ., ( } iJ
4" to 6" Transition: \ g
Length of Service:
1T7
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
Record Number
i`
For information call 651.470.2788
Number of stacks / Entered 5,L at . '
i
Phony t 17 ) iat ��
Obstruction
Unable to push past
feet
Notes
or am
Time
• ' O Pm
�-
Inspector Signature
ar /f / esr
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
/ 2:
t
Yellow Copy: City of Eagan Pink Copy: SEH
v