4730 Westminster Cir - Inspection Form4 City of 1,a ii
Residential Sanitary Sewer Service
Compliance Inspection
/ F /i OA
Date r /1.4 �°"/ /
Name/
RID Number
House Number
rem
Alternative Mailing Address
° • i go am
Time _Ai ' O pm
,� 0:wner/cupont Signature
Compliance
O No foundation drain connection
O No roof drain connection
0, Sump pit not connected to
1 sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Disk # L I : ] - L
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
Obstruction
Unable to push past
feet
•
•
Street Name
Phone , R G G
Inspector Signature
For information call 651.470.2788
Service Lateral Inspection Findings Number of stacks Entered S. L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
o am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discha
ged
Unknown
d otes
` mi l f ` " ° --
i
C , j . s
3 ,J I { ' ; J /
Total
Correctly
Incorrectly
Sump pumps
4
s /
A
Foundation drains
Roof drains
t
r
h.
4 City of 1,a ii
Residential Sanitary Sewer Service
Compliance Inspection
/ F /i OA
Date r /1.4 �°"/ /
Name/
RID Number
House Number
rem
Alternative Mailing Address
° • i go am
Time _Ai ' O pm
,� 0:wner/cupont Signature
Compliance
O No foundation drain connection
O No roof drain connection
0, Sump pit not connected to
1 sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Disk # L I : ] - L
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
Obstruction
Unable to push past
feet
•
•
Street Name
Phone , R G G
Inspector Signature
For information call 651.470.2788
Service Lateral Inspection Findings Number of stacks Entered S. L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
o am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH