2055 Coral Lane - Inspection FormEitj of.lia an
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
ND Number
House Number ,5� Street Name _ c2 (.. LA/
Alternative Mailing Address
For information call 651.47
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
,
No sump pump
o am
Time ! • • / '' 1 -16"
White Copy: Property Owner
Disk #
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
J-Li-L2Ji
Nor- Compliance
- i - i
Clear water conn9ct ns Unable toe push past
sanitary sewer _1� (4') I f
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
4" to 6"Transition: 1 ti--?'Length of Service:
Number of stacks Entered S.L.at
Yellow Copy: City of Eagan
Record Number
Phoni
L T • 4 ;7(°° Q am
Time • wpm
'11n4 ector Signature
Obstruction
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
A
Pink Copy: SFH
Notes
27
FF �
Y
F V /
6" !'r) t
€ /f
^
� �? r
f jT .. ..)
r�e' � ✓G %`1
c
;� j
/
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
f r
•
9l
Roofdrains
___..__ _._._
_. - --
-- ....._.
Eitj of.lia an
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
ND Number
House Number ,5� Street Name _ c2 (.. LA/
Alternative Mailing Address
For information call 651.47
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
,
No sump pump
o am
Time ! • • / '' 1 -16"
White Copy: Property Owner
Disk #
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
J-Li-L2Ji
Nor- Compliance
- i - i
Clear water conn9ct ns Unable toe push past
sanitary sewer _1� (4') I f
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
4" to 6"Transition: 1 ti--?'Length of Service:
Number of stacks Entered S.L.at
Yellow Copy: City of Eagan
Record Number
Phoni
L T • 4 ;7(°° Q am
Time • wpm
'11n4 ector Signature
Obstruction
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
A
Pink Copy: SFH