864 Ivy Lane - Inspection FormResidential Sanitary Sewer Service
•
Compliance lInsr)ecti(an
Date 1, I )
Name
PFD 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
4" to 6" Transition:
Sump pumps
Foundation thains
Roof drains
2
White Copy: Property Owneu
Total
Time
eDisk #
Street Name
Owner/Occupant Signature
Service Lateral Inspection Findings
Correctly
am
• pm
Incorrectly
L LJ
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
Length of Service:
Number Discharged
Record Number
Time
1
o am
•
• o pm
---- 2.-- ) —7-
Phone
Unknown
Yellow Copy: City of Eagan
Entered S L at
Obstruction
Unable to push past
feet
Notes
inspector Signature
Final Cleanout:
For infornaatiiDn call 651.470.2788
No Access
No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipefoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Sump pumps
Foundation drains
Roof drains
City of Ea pa
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name ' ;�if/'� /_i3isk #
PID Number
,
House Number Street Name
Alternative Mailing Address
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Poor Pipe Joints
Mineral Deposits
4" to 6 "Transition:
White Copy: Proper ty Owner
Total
Time
OwnerlOccupant Signature
J am' O am
Pm
SaglPipe Deflection
Damaged Pipe
Transition
�..
Correctly
Length of Service:
Incorrectly
y
Phone 7. . /
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
/ f
/
Number Discharged
Unknown
Yellow Copy: City of Eagan
Record Number
>�f
Obstruction
Unable to push past
feet
1 r r
ime •
Inspector Signature
` F f
Final Cleanout:
0 an
@ pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
1
•
Notes
1, ! �✓ b' ix
pp�
; (: �- 1 - fir- � _ •, 6
Pink Copy: SEH