2087 Shale Lane - Inspection FormResidential Sanitary Sewer Servic
Compliance Inspection
Name i ‘1.0
Date 7 / `� i•_•-1
f r
Time •_
PID Number
House Number Street Name
Alternative Mailing Address
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to b "Transition:
White Copy: Property Owner
UM
pm
Non - Compliance
ffl-
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
r
2 s r . 1
Time
•
•
oam
O pm
• Phone/
wA
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
q Q►ccess
No one n, „
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacics Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Servic
Compliance Inspection
Name i ‘1.0
Date 7 / `� i•_•-1
f r
Time •_
PID Number
House Number Street Name
Alternative Mailing Address
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to b "Transition:
White Copy: Property Owner
UM
pm
Non - Compliance
ffl-
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
r
2 s r . 1
Time
•
•
oam
O pm
• Phone/
wA
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
q Q►ccess
No one n, „
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacics Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH
