4835 Sheffield Lane - Inspection Form4 City of i;a . i
Residential Sanitary Sewer Service
Compliance Inspection
Date L
Name �r
PID Number
House Number
Alterr Mailing Address
/i 7
Transition
4" to 6" Transition:
qy —
f l ,�
Street Name
Di5k#FT
)
Phone _ . 1' - / • _
Compliance
O No foundation drain connection
O No roof drain connection
V
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
Time t•• r •
ci am
O pm
air-ter/Occupant Signature
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
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S,
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe r' ; J
3
Length of Service:
Yellow Copy: City of Eagan
r
Record Number I ' )
Time
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
• o pm
Inspector Signature i .
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
,
- -
;�..�f i P
r , ^ � 7 .., r _
- , =tea
) f
1
�—�.
i -)
,
i
7'�.- .. J i
-e,7
s
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
f�
Foundation drains
Roof drains
r a - (�
4 City of i;a . i
Residential Sanitary Sewer Service
Compliance Inspection
Date L
Name �r
PID Number
House Number
Alterr Mailing Address
/i 7
Transition
4" to 6" Transition:
qy —
f l ,�
Street Name
Di5k#FT
)
Phone _ . 1' - / • _
Compliance
O No foundation drain connection
O No roof drain connection
V
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
Time t•• r •
ci am
O pm
air-ter/Occupant Signature
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
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S,
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe r' ; J
3
Length of Service:
Yellow Copy: City of Eagan
r
Record Number I ' )
Time
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
• o pm
Inspector Signature i .
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH