4774 Eriks Blvd - Inspection Form4 11111. . City f Na an
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date )s
Name
4" to 6 "Transition:
I
' i9�s't Disk #
.
Time
.tea ' Q a
p
P[D Number
House Number Z7.2.1 Street Name
Alternative Mailing Address
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Service Lateral Inspection Findings
Roots
O
O
O
O
O
Non — Compliance
For information call 651.470.2788
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Final Cleanout:
• o am
• o pm
Phone r 2 - 7 r '�
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L.at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
1
Number
Correctly
Discharged
Incorrectly Unknown
N otes
= /) _ y am
% ) .
. - .s, j ° " d fir' :.a._•
'{ �° `'` �'` f ' % ° ?e. //
Total
Sump pumps
f \
' , #
j '
m , �_ 3_
Foundation drains
Roo{ drains
4 11111. . City f Na an
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date )s
Name
4" to 6 "Transition:
I
' i9�s't Disk #
.
Time
.tea ' Q a
p
P[D Number
House Number Z7.2.1 Street Name
Alternative Mailing Address
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Service Lateral Inspection Findings
Roots
O
O
O
O
O
Non — Compliance
For information call 651.470.2788
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Final Cleanout:
• o am
• o pm
Phone r 2 - 7 r '�
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L.at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
1