4755 London Lane - Inspection FormCity of Eap,ao
Residential Sanitary Sewer Service
Compliance Inspection
.` P
Date 1/ j/ ? / / /( s'
Name.
PID Number
House Number
Alternative Mailing,Address
1'
Compliance
O No foundation drain connection
O No roof drain connection
Y Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Proper Owner
Time
! Disk #
:.? Street Name
$ i \
g wnerl ; ccupant Signature
,1
9 am
pm
Length of Service:
Yellow Copy: City of Eagan
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
Record Number
Time
7m l
! Phone
•
fnspeccor Signature
Obstruction
Unable to push past
feet
Final Cleanout:
Dam
•
• O pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number. of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
)
Pink Copy: SEH
Number Discharged
Notes
1 /
r:
' - ., s~` e.' rr's ,. . „„
f
1
%S`'`ri '� 'd'� °`mow_ � e ” " " �*
Total
Correctly
Incorrectly
Unknown
Sump pumps
/
r
mow...
j
Foundation drains
Roof drains!
9 -- .) ,
City of Eap,ao
Residential Sanitary Sewer Service
Compliance Inspection
.` P
Date 1/ j/ ? / / /( s'
Name.
PID Number
House Number
Alternative Mailing,Address
1'
Compliance
O No foundation drain connection
O No roof drain connection
Y Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Proper Owner
Time
! Disk #
:.? Street Name
$ i \
g wnerl ; ccupant Signature
,1
9 am
pm
Length of Service:
Yellow Copy: City of Eagan
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
Record Number
Time
7m l
! Phone
•
fnspeccor Signature
Obstruction
Unable to push past
feet
Final Cleanout:
Dam
•
• O pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number. of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
)
Pink Copy: SEH