4772 London Lane - Inspection FormT City F1 Fa a°
Residential Sanitary Sewer Service
Compliance Inspection
Date 9i
2
( /
House Number
Time., am
? T
Name d , Disk #
PID Number
Street Name
Alternative Mailing Address
Owner /Occupant 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
For information calf 651.470.2788
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
—TM PI Time
Number of stacks Entered S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
SagJPipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
White Copy: Property Owner
d ■d? - / /, d s
U/
Length of Service:
Yellow Copy: City of Eagan
Record Number
.� F
• o am
• -- o pm
Phone r . ` � ./,4 . 'i
Obstruction
Unable to push past
feet
inspector Signature 1 ) i )
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
- _ /A
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Notes
.- Y , -; ,� i
-. .. /%" . 0/2 "� -'
- ��_ . ) - f _ c
1 _
y i
}
` i
Total
Incorrectly
Unknown
Sump pumps
\,,
Foundation drains
Roof drains
/
T City F1 Fa a°
Residential Sanitary Sewer Service
Compliance Inspection
Date 9i
2
( /
House Number
Time., am
? T
Name d , Disk #
PID Number
Street Name
Alternative Mailing Address
Owner /Occupant 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
For information calf 651.470.2788
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
—TM PI Time
Number of stacks Entered S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
SagJPipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
White Copy: Property Owner
d ■d? - / /, d s
U/
Length of Service:
Yellow Copy: City of Eagan
Record Number
.� F
• o am
• -- o pm
Phone r . ` � ./,4 . 'i
Obstruction
Unable to push past
feet
inspector Signature 1 ) i )
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
- _ /A
Final Cleanout:
Pink Copy: SEH