868 Trails End Rd - Inspection FormCity of h
Residential Sanitary Sewer Service
Cornpdiance Inspection
i • o am
Date [ . 1 r 4M / /2 Time ,1?" • O- 0,p
Name , //'
PID Number
Alternative Mailing Address
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
4" to 6" Transition:
White Copy: Property Owner
Disk #
House Number Street Name
Owner /Occupant Signature
_1 1E1-
For information call 651
Service Lateral Inspection Findings
Roots
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
1
Length of Service:
Record Number
r:
Time
Pone ! . � '7--J
.''Tspector Signature
Obstruction
Unable to push past
feet
• o am
• O pm
Entered S
Final Cleanout:
Notes ,
• ti.
Lt. A //
% '` /
N o Access
O No one in
Access to service
lateral needed
O Inspection
refused
Vic:
Yellow Copy: City of Eagan Pink Copy: SEH
Number.
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of h
Residential Sanitary Sewer Service
Cornpdiance Inspection
i • o am
Date [ . 1 r 4M / /2 Time ,1?" • O- 0,p
Name , //'
PID Number
Alternative Mailing Address
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
4" to 6" Transition:
White Copy: Property Owner
Disk #
House Number Street Name
Owner /Occupant Signature
_1 1E1-
For information call 651
Service Lateral Inspection Findings
Roots
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
1
Length of Service:
Record Number
r:
Time
Pone ! . � '7--J
.''Tspector Signature
Obstruction
Unable to push past
feet
• o am
• O pm
Entered S
Final Cleanout:
Notes ,
• ti.
Lt. A //
% '` /
N o Access
O No one in
Access to service
lateral needed
O Inspection
refused
Vic:
Yellow Copy: City of Eagan Pink Copy: SEH
41 111111 0.
Cit,y of Etipii
Residential Sanitary Sewel Service
Compliance Inspection
Date /. / /
Name 7 /74.
PID Number -
House Number
Poor Pipe joints
4" to 6"Transition:
Alternative Mailing Address
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
Service Lateral Inspection Findings
Roots
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
• am
Time
Disk #
Street Name
Owner/Ocapa nt Signature
Record Number
r
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
Time
Number of stacks Entered S L at
Length of Service:
Yellow Copy: City of Eagan
I f
Lc
r
•
•
Pone 71 /./.4 '
v.7
.71 ector Signature
For information call 651.4702788
Obstruction
Unable to push past
feet
Final Cleanout:
Notes A
0
o am
0 Prfl
No Access
O No one in
Access to service
lateral needed
o Inspection
refused
/-4Dic 6/- -
/
Pink Copy: SF H
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
41 111111 0.
Cit,y of Etipii
Residential Sanitary Sewel Service
Compliance Inspection
Date /. / /
Name 7 /74.
PID Number -
House Number
Poor Pipe joints
4" to 6"Transition:
Alternative Mailing Address
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
Service Lateral Inspection Findings
Roots
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
• am
Time
Disk #
Street Name
Owner/Ocapa nt Signature
Record Number
r
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
Time
Number of stacks Entered S L at
Length of Service:
Yellow Copy: City of Eagan
I f
Lc
r
•
•
Pone 71 /./.4 '
v.7
.71 ector Signature
For information call 651.4702788
Obstruction
Unable to push past
feet
Final Cleanout:
Notes A
0
o am
0 Prfl
No Access
O No one in
Access to service
lateral needed
o Inspection
refused
/-4Dic 6/- -
/
Pink Copy: SF H