796 Wescott Square - Inspection Form10. City of Y �
Residential Sanitary Sewer Service
Compliance Inspection
-'
Date / 1 ' / Time •
Name
�x
Roots
Poor Pipe joints
Mineral Deposits
PID Number.
House Number - Street Name
Alternative Mailing Address
•
Owner /Occupant Signature
Compliance
O No foundation drain connection
i No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
am
6 pm
3 �
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
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: pity of Eagan
Record Number
• am
Time.' • 0 pm
Phone ri r —
Obstruction
Unable to push past
feet
inspector
(1
7
` Final Cleanout:
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH
Total
Notes
z
C.� -' • f
3
�
;
{
f
Y
�
f
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
L.-
--®
Foundation drains
Roof drains
x
i
ill
10. City of Y �
Residential Sanitary Sewer Service
Compliance Inspection
-'
Date / 1 ' / Time •
Name
�x
Roots
Poor Pipe joints
Mineral Deposits
PID Number.
House Number - Street Name
Alternative Mailing Address
•
Owner /Occupant Signature
Compliance
O No foundation drain connection
i No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
am
6 pm
3 �
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
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: pity of Eagan
Record Number
• am
Time.' • 0 pm
Phone ri r —
Obstruction
Unable to push past
feet
inspector
(1
7
` Final Cleanout:
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH