715 Brentwood Lane - Inspection FormA ll. City at tralan
Residential Sanitary Sewer Service
Compliance Inspection
Date` / / /
Name _ r ° � r .t� ' =a Disk #
PID Number
House Number
Alternative Mailing Address
ii
1 ;;t
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
r
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
f
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
Total
Correctly
Number Discharged
White Copy: Property Owner
� fp am
Time i� pm
„„:7 ! 2 Street Name
Owner /Occupant Signature
.. T mot...
f
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
_ I
T ' Entered S at
L
Number of stacks ..
I
Length of Service:
Record Number j
Notes
Time
-
Inspector Signature
Obstruction
Unable to push past
feet
• ma! ✓ am
• pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH