762 Elrene Ct - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date/
Name
PID Number
Street Name
Alternative Mailing Address
House Number
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
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
•
Time •
pr am
Am
Phone
,
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
e O pm
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date/
Name
PID Number
Street Name
Alternative Mailing Address
House Number
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
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
•
Time •
pr am
Am
Phone
,
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
e O pm
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance Inspection
Dat 1
Alternative Mailing Address
Name
P[D Number
House Number
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
t ; . Street Name
Owner /Occupant Signature
Service Lateral inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Ownei
�'• ,, Dam
Time • p
L]-[11
Phone ).- f I
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:
Yellow Copy: City of Eagan
Record Number.
Obstruction
Unable to push past
feet
Entered S L. at
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
Time
•
•
Inspector Signature
Final Cleanout:
o am
o pm
ccess
No one in
O Access to service
lateral needed
O Inspection
r efused
Pink Copy: SEH
Number
Cor'rectly
Discharged
Incorr ectly Unknown
Total
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Dat 1
Alternative Mailing Address
Name
P[D Number
House Number
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
t ; . Street Name
Owner /Occupant Signature
Service Lateral inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Ownei
�'• ,, Dam
Time • p
L]-[11
Phone ).- f I
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:
Yellow Copy: City of Eagan
Record Number.
Obstruction
Unable to push past
feet
Entered S L. at
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
Time
•
•
Inspector Signature
Final Cleanout:
o am
o pm
ccess
No one in
O Access to service
lateral needed
O Inspection
r efused
Pink Copy: SEH
City of i3011
Residential Sanitary Sewer Service
Compliance inspection
Date : ` / /
Name
PID Number
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
. A
::Q Sump pit not connected to
v. sanitary sewer
O Sump pump properly piped
s
` No sump pump
4" to 6"Transition:
White Copy: Property Owner
Time
✓.;,y; f Disk #
Service Lateral Inspection Findings
o am
*Om
Number of stacks
m --
House Number .' f :- Street Name ! ; ;'t/ - ( 7
Alternative Mailing Address
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
Phone
Time
Obstruction
Unable to push past
feet.
Entered S L at
Final Cleanout:
• O am
• O pm
• /nspectar Signature
For information call 65 1.470.2788
No Access
O No one in
/9 Access to service
1 lateral needed
O Inspection
refused
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
.
r
1 i i ,
z
,
.`v r3
� r
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
' y
Foundation drains
Roof drains
City of i3011
Residential Sanitary Sewer Service
Compliance inspection
Date : ` / /
Name
PID Number
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
. A
::Q Sump pit not connected to
v. sanitary sewer
O Sump pump properly piped
s
` No sump pump
4" to 6"Transition:
White Copy: Property Owner
Time
✓.;,y; f Disk #
Service Lateral Inspection Findings
o am
*Om
Number of stacks
m --
House Number .' f :- Street Name ! ; ;'t/ - ( 7
Alternative Mailing Address
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
Phone
Time
Obstruction
Unable to push past
feet.
Entered S L at
Final Cleanout:
• O am
• O pm
• /nspectar Signature
For information call 65 1.470.2788
No Access
O No one in
/9 Access to service
1 lateral needed
O Inspection
refused
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH