4629 Kingsbury Dr - Inspection Form4 CitY fit Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date /l' / z'/ 1
Name
PFD Number
j----),(2
House Number Street Name
J
Alternative Mailing Address
/
Owner /Occupant
t "V (ram
Time :`? •c pm
i
Disk #
Signature
L
Record Number
Time
Phone
)
m }
1
O am
•
• O pm
Inspector Signature 1 . i , y
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
i'. sewer
r
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
2
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered 5 L at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Number
Correctl
Discharged
Notes
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,� / / j
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Total
Incorrectly
Unknown
-
Sump pumps
Foundation drains
Roof drains
/
4 CitY fit Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date /l' / z'/ 1
Name
PFD Number
j----),(2
House Number Street Name
J
Alternative Mailing Address
/
Owner /Occupant
t "V (ram
Time :`? •c pm
i
Disk #
Signature
L
Record Number
Time
Phone
)
m }
1
O am
•
• O pm
Inspector Signature 1 . i , y
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
i'. sewer
r
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
2
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered 5 L at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH