3685 Windtree Dr - Inspection Form4. City of tap
Residential Sanitary Sewer Service
Compliance Inspection
Date / I 1/
Name
)
PID Number
/ 7_":"
House Number . Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy:iPeopet ty Owner
Time
Owner/Occupant Signature
• O am
• ,4 pm
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Number of stacks
Yellow Copy: City of f ag
Record Number
Time
Phone
Inspector Signature
Obstruction
Unable to push past
feet
Entered St at
Notes
/ 4
am
Pm
/
No Access
O No one in
1 7)
O Access to service
lateral needed
O Inspection
refused
Length of Service: Final Cleanout
) A ./(
/ /./f
)
,1
1
Pink Copy. SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
,I 7._
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,--'.--:, ) ,',-/
-- _,..
' • • ; ,./
.' (
,----?..-
Foundation drains
''' .
IIIIIIIIIN
Roof drains :
4. City of tap
Residential Sanitary Sewer Service
Compliance Inspection
Date / I 1/
Name
)
PID Number
/ 7_":"
House Number . Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy:iPeopet ty Owner
Time
Owner/Occupant Signature
• O am
• ,4 pm
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Number of stacks
Yellow Copy: City of f ag
Record Number
Time
Phone
Inspector Signature
Obstruction
Unable to push past
feet
Entered St at
Notes
/ 4
am
Pm
/
No Access
O No one in
1 7)
O Access to service
lateral needed
O Inspection
refused
Length of Service: Final Cleanout
) A ./(
/ /./f
)
,1
1
Pink Copy. SEH
Residential Sanitary Sewer Service
Compliance Inspection
Date ' 1 / r Time
✓'�
j) JDisk #
PID Number
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
4" to 6" Transition:
Damaged Pipe
•
•
am
pm
LLI - [L]
House Number �Y7- Street Name l l �L =`- � - f�
Phone ( !
For information call 651.470.2788
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
Number of stacks Entered S.l. at
Service Lateral Inspection Findings
Roots
- J / Poor ipe f oints �� `; `'`� ``
_-
f
Minera Deposits - 2 _ � . - - "
Sag /Pipe Deflection .,/ . - ` "` .,47/.- _72 r
,7 :,( .A
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
f
• O am
• O pm
No Access
O No one in
Final Cleanout:
Access to service
Iatgrs7 / ?7 l r
O Inspection
r efused
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date ' 1 / r Time
✓'�
j) JDisk #
PID Number
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
4" to 6" Transition:
Damaged Pipe
•
•
am
pm
LLI - [L]
House Number �Y7- Street Name l l �L =`- � - f�
Phone ( !
For information call 651.470.2788
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
Number of stacks Entered S.l. at
Service Lateral Inspection Findings
Roots
- J / Poor ipe f oints �� `; `'`� ``
_-
f
Minera Deposits - 2 _ � . - - "
Sag /Pipe Deflection .,/ . - ` "` .,47/.- _72 r
,7 :,( .A
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
f
• O am
• O pm
No Access
O No one in
Final Cleanout:
Access to service
Iatgrs7 / ?7 l r
O Inspection
r efused
Pink Copy: SEH
City of EaRAD
Residential Sanitary Sewer Service
Compliance Inspection
I
Date i' / // /
..
N am e,
PID Number
'? 77
House Number ,' ( �/ Street Name
Alternative MailingAddress
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Time
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
/1
• C J am
1 pm
L.
Length of Service:
Record Number
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor kipe)oints 7
r r
Mineralpposits �' .(r' r 17 C.,) I
/ - - --. -)
SaglPi�e Deflection �: ,�'" -�..� � �"�,� ,�'. �'.' �"" ? .--- -- -�. --'
Damaged Pipe
Obstruction
Unable to push past
feet.
Time
Notes
Inspector Signature
� Oam
•
• O pm
Phone ./ Y � �
For information caII 65 .:
i
Transition
Final Cleanout:
No Access
O No one in
/T Access to service
lat ra need jd�
0 Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of EaRAD
Residential Sanitary Sewer Service
Compliance Inspection
I
Date i' / // /
..
N am e,
PID Number
'? 77
House Number ,' ( �/ Street Name
Alternative MailingAddress
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Time
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
/1
• C J am
1 pm
L.
Length of Service:
Record Number
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor kipe)oints 7
r r
Mineralpposits �' .(r' r 17 C.,) I
/ - - --. -)
SaglPi�e Deflection �: ,�'" -�..� � �"�,� ,�'. �'.' �"" ? .--- -- -�. --'
Damaged Pipe
Obstruction
Unable to push past
feet.
Time
Notes
Inspector Signature
� Oam
•
• O pm
Phone ./ Y � �
For information caII 65 .:
i
Transition
Final Cleanout:
No Access
O No one in
/T Access to service
lat ra need jd�
0 Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH