865 Great Oaks Tr - Inspection Form4 City of Elan
Residential Sanitary Sewer Service
Compliance Inspection
Date F. / / Time
Name
PID Number
House Number e7C�J
Alternative MailingAddress
For information call 651.470.2788
Compliance
r
No foundation drain connection
3 No roof drain connection
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
SaglPipe Deflection
Damaged Pipe
Transition
4" to b" Transition: J IL?
White Copy: Proper ry Owner
!
Disk #
`\ Owner /Occupant Signature
2
)
1 '
Street Name C' ' / ! 2 "- ( ik'?
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 .�f' •
{ A c
Length of Service:
Number Discharged
Sump pumps
Foundation drains
Roof drains
Total
Correctly
,
Incorrectly Unknown
51
Record Number
•
Time •
Phone ) ) - __ 17 1
Inspector Signature
Obstruction
Unable to push past
feet
N otes
6 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: / 1- 7 1-
Yellow Copy: City of Eagan Pink Copy: SEH