4613 Cambridge Dr - Inspection FormCity if Ea ao
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 /
Name
PID Number
House Number p/
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
4 Sump pit not connected to
' sanitary sewer
Q Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
-- '116,1: - )d am
Time • O pm
Disk #
Street Name
-m-
Number. of stacks
Length of Service:
v
Record Number
Time
Phone t
Non — Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
o am
O Pm
inspector Signature ; \,) )
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Tr ansition
Pink Copy: SEH
/j r+ A y
l �
Total
Notes )
,
` -r
', y
��
.L. - -i"� '
1
2
'
� .0
`..
t
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
'
,
Foundation drain
Roof drains
i
City if Ea ao
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 /
Name
PID Number
House Number p/
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
4 Sump pit not connected to
' sanitary sewer
Q Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
-- '116,1: - )d am
Time • O pm
Disk #
Street Name
-m-
Number. of stacks
Length of Service:
v
Record Number
Time
Phone t
Non — Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
o am
O Pm
inspector Signature ; \,) )
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Tr ansition
Pink Copy: SEH
/j r+ A y
l �