3778 Windtree Dr - Inspection FormResidential Sanitary Sewer Service
r Clt Eapa Compliance Inspection
Date M / //j .�
Name \J t 7 („
Alternative MailingAddress
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
Q c) am
Time r�. Y� O pm
Disk #
PID Number
J/ House Number £• -' ' Street Name f' /4/ � .
OwnerlOccupant Signature
i-
For information call 651
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 Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
/9
Time
r
f �Ahon t e ?� f
/S 2
{IA e l
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
• O Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Notes',
; dt� � t- Cia , ' ..; 0
f?� ./f ,� , A
r'�''✓ .pfd` fr VF
12 '
r -
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
r Clt Eapa Compliance Inspection
Date M / //j .�
Name \J t 7 („
Alternative MailingAddress
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
Q c) am
Time r�. Y� O pm
Disk #
PID Number
J/ House Number £• -' ' Street Name f' /4/ � .
OwnerlOccupant Signature
i-
For information call 651
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 Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
/9
Time
r
f �Ahon t e ?� f
/S 2
{IA e l
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
• O Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
City of hagari
Residential Sanitary Sewer Service
Compliance Inspection
Date (971 / 1 - )U
Name A9 f ' . Y
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
For information call 651
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
White Copy: Pr operty Owner
0 am
Time olo O pm
Owner /Occupant Signature
Street Name r° °%.t/ 7- /9,
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
,Phone
Time
Obstruction
Unable to push past
feet.
Number of stacks Entered S L at
/Inspector Signature
Length of Ser vice: Final Cleanout:
p am
•
• o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
''2J( 7-7 4- I
Yellow Copy: City of Eagan Pink Copy: SEH
Correctly
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of hagari
Residential Sanitary Sewer Service
Compliance Inspection
Date (971 / 1 - )U
Name A9 f ' . Y
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
For information call 651
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
White Copy: Pr operty Owner
0 am
Time olo O pm
Owner /Occupant Signature
Street Name r° °%.t/ 7- /9,
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
,Phone
Time
Obstruction
Unable to push past
feet.
Number of stacks Entered S L at
/Inspector Signature
Length of Ser vice: Final Cleanout:
p am
•
• o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
''2J( 7-7 4- I
Yellow Copy: City of Eagan Pink Copy: SEH
Sump pumps
t` i
Foundation drains
Roof drains
f
Ji
City of Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date'/ / .•1
Name� n
PID Number
House Number
Alternative Mailing Address
For information call 65
Compliance
el No foundation drain connection
No roof drain connection
Disk#
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
Time l •
c Street Name
Owner /Occupant Signature
am
Pm
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 r7
Record Number
Time
Phone ,!)' 1
inspector Signature
Obstruction
Unable to push past
feet
• . O,am
• pm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
r efused
Service Lateral Inspection Findings Ni}Fnber of stacks .' Entered S.E_..at
J
Roots ! i f
Poor PipeJoints I f / +.: d 1 ,
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
'Transition ) �. _� J
I
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
_ -I-Final Cle nout:r-- 7 '1` t
Notes
Yellow Copy: City of Eagan Pink Copy: SEH