4247 Sandstone Dr - Inspection FormCity or �,a a!
Residential Sanitary Sewer Service
Compliance inspection
Dated )
Name j / Disk #
Aker native Mailing Address
}
4" to 6" Transition:
1
White Copy: Pr oper ty Owner
'J
Time am
1i• pm
OwneFJOccupant 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
Service Lateral Inspection Findings Number.' of stacks Entered S .. at
Roots
Poor €pe Joints x r
\ _7 ,
Minera,Deposits
Sag /Pip'e Deflection `? -° '1;"
Damaged Pipe r '. `2:. ? 1� '1 7- 1
'
Transition �_�., t ? : • r'ydsf;.2 ,�� - 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
-r Li-LIJ
Length of Service:
Yellow Copy: City of Eagan.
Notes
Time
Record Number
� 2
Phone
inspector Signature
Obstruction
Unable to push past
feet
• O am
• O pm
PID Number
House Number 4 4 -F7 - Street Name _ r r�'
For information call 651
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
/ t
Pink Copy: SEH
d�_
Number
Discharged
Total
Correctly
incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City or �,a a!
Residential Sanitary Sewer Service
Compliance inspection
Dated )
Name j / Disk #
Aker native Mailing Address
}
4" to 6" Transition:
1
White Copy: Pr oper ty Owner
'J
Time am
1i• pm
OwneFJOccupant 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
Service Lateral Inspection Findings Number.' of stacks Entered S .. at
Roots
Poor €pe Joints x r
\ _7 ,
Minera,Deposits
Sag /Pip'e Deflection `? -° '1;"
Damaged Pipe r '. `2:. ? 1� '1 7- 1
'
Transition �_�., t ? : • r'ydsf;.2 ,�� - 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
-r Li-LIJ
Length of Service:
Yellow Copy: City of Eagan.
Notes
Time
Record Number
� 2
Phone
inspector Signature
Obstruction
Unable to push past
feet
• O am
• O pm
PID Number
House Number 4 4 -F7 - Street Name _ r r�'
For information call 651
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
/ t
Pink Copy: SEH
d�_
Name
-
PID Number
House Number
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:
/Street Name _ :1, % ✓
0wne>p0ccupant Signature
White Copy: Property Owner
Time
f0 pm
Dsk#110—L
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
City Capp
Residential San Sewer Service
Compliance Inspection
•
•
..._- 3
Phone /. - l 2 1
Inspector Signature
Obstruction
Unable to push past
feet
o am
O pm
For information .call 651.470.2788
No Access
O No one in
Access to service
11 lateral needed
O Inspection )
refused
Service Lateral Inspection Findings Number of stacks Entered S. L. at
Roots
Poor ipejoints ,--- -- c:a a -777, , _ . 3 , - ...- -°
Minera Deposits , ), -�" _;., ,� !' - _.,� / ��y ,/-
- ,� . I
p
}
SagiPi�Se\Defiection -- ?,-- °� 7- ) — a L°- °`? '7 i?f 7/1 /2 °7 `P; f.- .,-' ":27 "
f
Damaged Pipe / " 3 :-/ f :� T\ ,: ? ) � �, / =rte
Transition /i% J'f' - � - r, `- r r ' _ " r% If
Final Cleanout:
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
-.
Unknown
Sump pumps
Foundation drains
Roof drains
Name
-
PID Number
House Number
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:
/Street Name _ :1, % ✓
0wne>p0ccupant Signature
White Copy: Property Owner
Time
f0 pm
Dsk#110—L
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
City Capp
Residential San Sewer Service
Compliance Inspection
•
•
..._- 3
Phone /. - l 2 1
Inspector Signature
Obstruction
Unable to push past
feet
o am
O pm
For information .call 651.470.2788
No Access
O No one in
Access to service
11 lateral needed
O Inspection )
refused
Service Lateral Inspection Findings Number of stacks Entered S. L. at
Roots
Poor ipejoints ,--- -- c:a a -777, , _ . 3 , - ...- -°
Minera Deposits , ), -�" _;., ,� !' - _.,� / ��y ,/-
- ,� . I
p
}
SagiPi�Se\Defiection -- ?,-- °� 7- ) — a L°- °`? '7 i?f 7/1 /2 °7 `P; f.- .,-' ":27 "
f
Damaged Pipe / " 3 :-/ f :� T\ ,: ? ) � �, / =rte
Transition /i% J'f' - � - r, `- r r ' _ " r% If
Final Cleanout:
Pink Copy: SEH
� s
Number
Correctly
Discharged
Incorrectly Unknown
Notes
4:0 ,� °" r Z,;:
f r °
o� w rr y 3
3 i { "� 'ice J� „,. w" .;,, Li, ..u,
_"
Total
Sump pumps
Foundation drains
--
Roof drains
,. ""
41 City of i;a afl
Residential Sanitary Sewer Service
Compliance Inspection
Name • Tt I /( t JJ/ 7e
PID Number
Alternative Mailing Address
Compliance
O Q 'Jo foundation drain connection
' No roof drain connection
7' Sump pit not connected to
sanitary sewer
Ad Sump pump properly piped
0 No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Time .+ }t'
Disk #
t 0 am
,erpm
Owner /Occupant Signature
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
Length of Service:
Yellow Copy: City of Eagan
."--
Record Number f
,r
House Number Street Name w ffi =• A/7 -e4 ..,
Obstruction
Unable to push past
feet
Time h • 4..
Phone )
/ inspector Signature
For information tall 651.47 0.2788
Service Lateral Inspection Findings Number of stacks ( Entered S.L.at SW6e. (P
Roots
Poor Pipe Joints
Mineral Deposits
Deflection
Damaged Pipe
Transition 1 /1/4.9 f i, ' `� L• r'' �' �
Final Cleanout:
0 a
Pm
NOIAccess
O
0
No one in
Access to service
lateral needed
0 Inspection
refused
Pink Copy: SEH