1491 Thomas Lane - Inspection Form41 City of Eag,ao
Residential Sanitary Sewer Service
Compliance Inspection
Date -//,. /
Name , a }, Disk #
PID Number
House Number
Alternative Mailing Address
.. :(..P4
C
OwnerfOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Owner
1,4 am
Time if
• , prr:
Street Name
./0
Phone /---)
For information call 651.470.2788
Non—Compliance
0
Hil
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
.1
Inspector Signature
Obstruction
Unable to push past
feet
• am
• 0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
r'r
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
< },:.... _ ) ) 6 :.
„ , ...
.. • ../ ...-, A r
,:
' ,
Total
Sump pumps
,
,,,--
- '1' ,, -.`"
/ r
, 0
Foundation drains
1111
1111111111
Roof drains
I . 1
41 City of Eag,ao
Residential Sanitary Sewer Service
Compliance Inspection
Date -//,. /
Name , a }, Disk #
PID Number
House Number
Alternative Mailing Address
.. :(..P4
C
OwnerfOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Owner
1,4 am
Time if
• , prr:
Street Name
./0
Phone /---)
For information call 651.470.2788
Non—Compliance
0
Hil
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
.1
Inspector Signature
Obstruction
Unable to push past
feet
• am
• 0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
r'r
Pink Copy: SEH