4256 Diamond Dr - Inspection Form4
City of Papa
Res der>itiai Sanitary Sewer Service
Compliance Inspection
� 5 f
Date 1 _ K
Name
PID Number
House Number -r -- %'%Street Name
Alternative Mailing Address
ir
For information call 651.470.2788
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 Number of stacks Entered S L at
Roots
Poor Pipe joints
4" to b "Transition:
White Copy: Property Owner
Ow er /Occupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
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
Phone ; `" ._ 4
Length of Service: Final Cleanout:
Yellow Copy: City of Eagan
Record Number
Time
1
Inspector Signature
Obstruction
Unable to push past
feet
Notes
1
• o am
• o pm
No Access
0 " No one in
Access to service
f lateral needed- -
O Inspection � s1/
refused
' --- � -= / V i."1"---
. 7:7 �/( !!,i7V ! " 1---2--11) 0 ' ""--.' f_
•. ,,_..-
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
4
City of Papa
Res der>itiai Sanitary Sewer Service
Compliance Inspection
� 5 f
Date 1 _ K
Name
PID Number
House Number -r -- %'%Street Name
Alternative Mailing Address
ir
For information call 651.470.2788
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 Number of stacks Entered S L at
Roots
Poor Pipe joints
4" to b "Transition:
White Copy: Property Owner
Ow er /Occupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
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
Phone ; `" ._ 4
Length of Service: Final Cleanout:
Yellow Copy: City of Eagan
Record Number
Time
1
Inspector Signature
Obstruction
Unable to push past
feet
Notes
1
• o am
• o pm
No Access
0 " No one in
Access to service
f lateral needed- -
O Inspection � s1/
refused
' --- � -= / V i."1"---
. 7:7 �/( !!,i7V ! " 1---2--11) 0 ' ""--.' f_
•. ,,_..-
City of Ialaa
Fiesideritial Sanitary ; Sewer Service
Compliance Inspection
Dated 1 J i , Time _`` ¢y p m
rte{ i
Name / 1:, ;i� " i 7/7.7" Disk#
i
PID Number
House 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
Ser vice Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
n :Street Name
Ow er /Occupant Signature
FE Di
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
Record Number 1
Time
o am
•
• o pm
Length of Service:
Phone
Inspector Signature
For information call 651
Obstruction
Unable to push past
feet
No Access
0 , No one in
Access to service
lateral needed.-- -
O Inspection -
refused
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Yellow Copy: City of Eagan r � z ? I I :'.~ ��. , � Copy .S H /
•
( 2_,„/
t ��
— /�
f i fr ( '
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of Ialaa
Fiesideritial Sanitary ; Sewer Service
Compliance Inspection
Dated 1 J i , Time _`` ¢y p m
rte{ i
Name / 1:, ;i� " i 7/7.7" Disk#
i
PID Number
House 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
Ser vice Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
n :Street Name
Ow er /Occupant Signature
FE Di
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
Record Number 1
Time
o am
•
• o pm
Length of Service:
Phone
Inspector Signature
For information call 651
Obstruction
Unable to push past
feet
No Access
0 , No one in
Access to service
lateral needed.-- -
O Inspection -
refused
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Yellow Copy: City of Eagan r � z ? I I :'.~ ��. , � Copy .S H /
•
( 2_,„/
t ��
— /�
f i fr ( '