4612 Cambridge Dr - Inspection Form411110. city co Residential Sanitary Sewer Service
Compliance Inspection
Date 1 j / /),/
Time •
•
Name •,,
, Disk #
PID Number
House Number
f i
/\
4
Compliance
O No foundation drain connection
' 0 1 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Proper ty Owner
) ) ••••"" /.;)
Street Name
OwnerOccupant Signature
Service Lateral Inspection Findings
4rTS
Pm
LLJ
Alternative Mailing Address
For information call 651.470.2788
Non-Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
0 Defective manholes
0 Sump pump connected to sanitary
/ sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
.-."'"-•'• I/ I
•
Damaged Pipe / /
Transition
)
/ Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
/
Phone)
•
•
o am
.L'ci pm
inspector Signature
Obstruction
Unable to push past
feet
Entered S L.at
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
=
Total
N otes ,
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.
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Number
D ischarged
Correctly
Incorrectly
Unknown
Sump pumps
I
Mill
(1
Foundation drains
IIIIIIIIIIIII
Roof drains
411110. city co Residential Sanitary Sewer Service
Compliance Inspection
Date 1 j / /),/
Time •
•
Name •,,
, Disk #
PID Number
House Number
f i
/\
4
Compliance
O No foundation drain connection
' 0 1 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Proper ty Owner
) ) ••••"" /.;)
Street Name
OwnerOccupant Signature
Service Lateral Inspection Findings
4rTS
Pm
LLJ
Alternative Mailing Address
For information call 651.470.2788
Non-Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
0 Defective manholes
0 Sump pump connected to sanitary
/ sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
.-."'"-•'• I/ I
•
Damaged Pipe / /
Transition
)
/ Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
/
Phone)
•
•
o am
.L'ci pm
inspector Signature
Obstruction
Unable to push past
feet
Entered S L.at
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
=