4791 Richard Lane - Inspection FormSump pumps
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Foundation drains
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Roof drains
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Cit y of Eagan
Residential Sanitary Sewer Service
Compliance Inspection
Date 0l )4/ 1
Narne rl � z T 1-
PID Number
House Number
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
' . /Ownerl6ccupant 57grrature
sanitary sewer
O Sump pump properly piped
O No sump pump
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Proper ty Owner
Disk #
;"7 Street Name
Number Discharged
otal
/1.
Time �� •
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1
\!.
Correctly
am
0 pm
Incorrectly
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Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
flexible sump pump piping
Unknown
Record Number
J Time
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Notes
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Alternative Mailing Address Phone "°" l - 'n f
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Inspector Signature
Obstruction
Unable to push past
feet
o am
O pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
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r
Length of Service: Final Cleanout:
c
1 1 i „/ J f
Yellow Copy: City of Eagan Pink Copy: SEH