1471 Richards Ct - Inspection FormCity ofl a n
Residential Sanitary Sewer Service
Compliance Inspection
f'
V))
D ate ( / {iv) I
Nam
PID Number
House Number
Compliance
O No foundation drain connection
O No roof drain connection
r ▪ 1 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
)a am
l� I�
6' pm
Disk #
ENNIO
Street Name ' 3
O
Alternative Mailing Address
Ow' nerlOccupanJ Signature
Flexible sump pump piping
Number of stacks
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
( Sump pump connected to sanitary
sewer
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number.
Phone
Time
. -_ Inspector Signature
Obstruction
Unable to push past
feet
Il
o am
•
o pm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Entered S.L. at
I ,, �
: r
1 • !t
Pink Copy: SEH
Final Cleanout:
Number
Cor rectiy
Discharged
Incorrectly
Notes
r p ; fir .. -. c: _,.. , _
Total
Unknow
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1
t :emu c: : - t' F , /
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/ .7-- - 1 i ,,
Sump pumps
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V
Foundation drains
Roof drains
i 1
\)
t
cam
City ofl a n
Residential Sanitary Sewer Service
Compliance Inspection
f'
V))
D ate ( / {iv) I
Nam
PID Number
House Number
Compliance
O No foundation drain connection
O No roof drain connection
r ▪ 1 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
)a am
l� I�
6' pm
Disk #
ENNIO
Street Name ' 3
O
Alternative Mailing Address
Ow' nerlOccupanJ Signature
Flexible sump pump piping
Number of stacks
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
( Sump pump connected to sanitary
sewer
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number.
Phone
Time
. -_ Inspector Signature
Obstruction
Unable to push past
feet
Il
o am
•
o pm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Entered S.L. at
I ,, �
: r
1 • !t
Pink Copy: SEH
Final Cleanout: