823 Wescott Square - Inspection Formi y o taloa
Residential Sanitary Sewer Service
Compliance Inspection
1]atewa l t 1 10
1-1 LfMr \P
Name
PO Number
_
House Number Street Name E _ 5
Alternative Mailing Address
f
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
4" to b "Transition:
White Copy: Property Owner
Compliance
No foundation drain connection
0 No roof drain connection
'6 Sump pit not connected to
sanitary sewer
d Sump pump properly piped
0 No sump pump
Time
Disk #
r\ fV"
OwnerlOccupant Signature
For information call 65 1.470.2788
Service Lateral Inspection Findings
ls0
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
1
t
• 00 O am
• April
Ltfl
Length of Service:
` f � r{ A
lnspecto /Signature
Record Number
ARE
Obstruction No Access
Unable to push past 0 No one in
feet
Entered 5 L at fi r -17) 1 t t
Notes
t
2 • 20' 0 a
Time ® O pm
Phone 6' • -2L1- gscr
TH-11. L. C, O.. Ef:
_.,47 r CARY FT
t Si a'^ Cr•...
O Access to service
lateral needed
O Inspection
refused
A E` 0,)
Final Cleanout:
X- k Nj €1 Vii- r , .. F t - 1 A, _ N1
X-
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Corr ectly
Incorrectly Unknown
Sump pumps
1
1
Foundation drains
Roof drains
i y o taloa
Residential Sanitary Sewer Service
Compliance Inspection
1]atewa l t 1 10
1-1 LfMr \P
Name
PO Number
_
House Number Street Name E _ 5
Alternative Mailing Address
f
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
4" to b "Transition:
White Copy: Property Owner
Compliance
No foundation drain connection
0 No roof drain connection
'6 Sump pit not connected to
sanitary sewer
d Sump pump properly piped
0 No sump pump
Time
Disk #
r\ fV"
OwnerlOccupant Signature
For information call 65 1.470.2788
Service Lateral Inspection Findings
ls0
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
1
t
• 00 O am
• April
Ltfl
Length of Service:
` f � r{ A
lnspecto /Signature
Record Number
ARE
Obstruction No Access
Unable to push past 0 No one in
feet
Entered 5 L at fi r -17) 1 t t
Notes
t
2 • 20' 0 a
Time ® O pm
Phone 6' • -2L1- gscr
TH-11. L. C, O.. Ef:
_.,47 r CARY FT
t Si a'^ Cr•...
O Access to service
lateral needed
O Inspection
refused
A E` 0,)
Final Cleanout:
X- k Nj €1 Vii- r , .. F t - 1 A, _ N1
X-
Yellow Copy: City of Eagan Pink Copy: SEH