4859 Richard Lane - Inspection FormCity of Eagau
Residential Sanitary Sewer Service
Compliance Inspection
1/ 2'2 ///'
Date �I I
Name - . � )
PID Number
House Number L 2 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
y r No roof drain connection
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: Propel ty Owner
Time -.® •
Disk #
O wnerlOccupant Signature
Or am
Pm
LLJ-[ILI ri
] Gi / � ff ]
Record Number
Time
O am
•
• O pm
Phone r:� _ ::; [ C
Inspector Signature ji a
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
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
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Correctly
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Incorrectly
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Unknown
Total
Sump pumps
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Foundation drains
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Roof drains
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City of Eagau
Residential Sanitary Sewer Service
Compliance Inspection
1/ 2'2 ///'
Date �I I
Name - . � )
PID Number
House Number L 2 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
y r No roof drain connection
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: Propel ty Owner
Time -.® •
Disk #
O wnerlOccupant Signature
Or am
Pm
LLJ-[ILI ri
] Gi / � ff ]
Record Number
Time
O am
•
• O pm
Phone r:� _ ::; [ C
Inspector Signature ji a
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
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH