1468 Thomas Lane - Inspection FormCity f ha n
Y �
Residential Sanitary Sewer Service
Compliance Inspection
r
Date i / () Time
i 1✓
Name. h �"!�' 1 r Disk #
Owner /Occu ant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Transition
4" to 6" Transition:
White Copy: Property Owner
•
PID Number / . �s
House Number J !,, Street Name„
7.
Alterna ivy 'riling Address ( i' / /7`
f -- -, /'/ f //
fl / ' /
atri
pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
a .
Record Number 1
rr
0 am
•
Time : o pm
Phone c
r
Inspector Signature )\ ' y V J i 6.4
For information call 651.470.2788
Obstruction
Unable to push past
feet
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 .._.-;
t 1 .
Final Cleanout:
Pink Copy: SEH
Total
Notes -
/
�` r
ie—
�
7
._,_
i
�.
-
1
!L_
� __....
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City f ha n
Y �
Residential Sanitary Sewer Service
Compliance Inspection
r
Date i / () Time
i 1✓
Name. h �"!�' 1 r Disk #
Owner /Occu ant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Transition
4" to 6" Transition:
White Copy: Property Owner
•
PID Number / . �s
House Number J !,, Street Name„
7.
Alterna ivy 'riling Address ( i' / /7`
f -- -, /'/ f //
fl / ' /
atri
pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
a .
Record Number 1
rr
0 am
•
Time : o pm
Phone c
r
Inspector Signature )\ ' y V J i 6.4
For information call 651.470.2788
Obstruction
Unable to push past
feet
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 .._.-;
t 1 .
Final Cleanout:
Pink Copy: SEH