4797 Richard Lane - Inspection FormSump pumps
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Foundation drains
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Roof drains
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Residential Sanitary Sewer Service
Compliance Inspection
Date /
• -
Name
PID Number
House Number / Street Name
Alternative jailing Address
1 ." - -, / _.„-.
f ., _ _.-- „„,
For information call 651.470.2788
Compliance
O No foundation drain connection
\ 4
No roof drain connection
S O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Propel ty Owner
•_Y-v 8
Time • /6 pm
Disk #
Owner/Occupant Signature
Phone
Non
O Clear water connections to
sanitary sewer.
O Service lateral defects
1 0 Defective manholes
0
Sump pump connected to sanitary
sewer
O Flexible sump pump piping
otal Correctly
Number of stacks
Length of Service:
Number Discharged
Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Entered S L at
Notes
0 am
•
- • 0 pm
Inspector Signature
7 i l. //‘ , // 11 ) 77,11 7
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipejoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
.11 - tt• I ...
:•••
Pink Copy: SEH