870 Wescott Square - Inspection Form4 City oil ap
Residential Sanitary Sewer Service
Compliance Inspection
Datef 1 ° 1 I Time.. • Pm
Name lti � �/ 1�__ � Disk #
PID Number
House Number
Transition
Mailing Address
4 r,
'v lr
OwnerlOccupant Signature
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
4" to 6" Transition: = 3 I
White Copy: Property Owner
15/
( 1 Street Name
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
Record Number
• Cw,' D � / am
Time •7 pm
Obstruction
Unable to push past
feet
Phoneme ..fi a,.
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Service Lateral Inspection Findings
Roots Poor Pipe Joints r' < /.,di / =-' - a">r.. " � ° �` ' - )
° r
Mineral Deposits r / s �-•- '`.' .. 2 " ) r ..�. r' °1 . -)_ = ... _ ;, :' r i fi t = '
Sag /Pipe Deflection / /-1/ 7 -? fll 4".! """ r "' L_.- � r 7 ` ` .. °'_'-7 / ^- = /
Damaged Pipe • / 1- «,-
- i Cd ) r r e J�fr � y p `�
t
Length of Service: C-'(i i I Final Cleanout:„„!
Yellow Copy: City of Eagan t ,� i = % 1,Pin .SOH
„� )
i J A �� ^'
•
Total
Notes
'.� -)-- i a
a1 7
A ` � -
ti:/!� :r
'1"--.'":1,--,, - _', 7,
3 '
B-
11
J
;"
':f ''
r' . c
v,
) _
7
/ ;
l
1
-'
s1
/ i 1 I
2-
)
�, ' C
v
�i .�
,� r y
I/. " .-
C
Number
Discharged
Correctly
Incorrectly
Unknown -'
Sump pumps
P P P
i ^;
- f
Foundation drains
Roof drains
� /
4 City oil ap
Residential Sanitary Sewer Service
Compliance Inspection
Datef 1 ° 1 I Time.. • Pm
Name lti � �/ 1�__ � Disk #
PID Number
House Number
Transition
Mailing Address
4 r,
'v lr
OwnerlOccupant Signature
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
4" to 6" Transition: = 3 I
White Copy: Property Owner
15/
( 1 Street Name
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
Record Number
• Cw,' D � / am
Time •7 pm
Obstruction
Unable to push past
feet
Phoneme ..fi a,.
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Service Lateral Inspection Findings
Roots Poor Pipe Joints r' < /.,di / =-' - a">r.. " � ° �` ' - )
° r
Mineral Deposits r / s �-•- '`.' .. 2 " ) r ..�. r' °1 . -)_ = ... _ ;, :' r i fi t = '
Sag /Pipe Deflection / /-1/ 7 -? fll 4".! """ r "' L_.- � r 7 ` ` .. °'_'-7 / ^- = /
Damaged Pipe • / 1- «,-
- i Cd ) r r e J�fr � y p `�
t
Length of Service: C-'(i i I Final Cleanout:„„!
Yellow Copy: City of Eagan t ,� i = % 1,Pin .SOH
„� )
i J A �� ^'
•