4814 Richard Lane - Inspection Form4
l.- City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
f
1
/1
J
House Number•
4” to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
q r Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Propel ty Owner
Time •.__�,,,
Disk #
r
l ,tea l
._!_= .' Street Name
rf
r /U1 )
,ffwnerliccupant Signature
Service Lateral Inspection Findings
am
o pm
Number of stacks
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
2
Obstruction
Unable to push past
feet
Si 1
O am
•
• o pm
Alternative Mailing Address Phone .! J 2 ..._ -
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
Transition
Final Cleanout:
Pink Copy: SEH
Total
Notes
i c__.
, r
. 71V7
_ ,
. T IT -
` , 5
;� , . .. _
..
F. .�j- J „_ f
_
fi
.-, l
f
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
/..
'
.,
'
�'....,--/))) .�
.•
Foundation drains
Roof drains
t
4
l.- City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
f
1
/1
J
House Number•
4” to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
q r Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Propel ty Owner
Time •.__�,,,
Disk #
r
l ,tea l
._!_= .' Street Name
rf
r /U1 )
,ffwnerliccupant Signature
Service Lateral Inspection Findings
am
o pm
Number of stacks
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
2
Obstruction
Unable to push past
feet
Si 1
O am
•
• o pm
Alternative Mailing Address Phone .! J 2 ..._ -
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
Transition
Final Cleanout:
Pink Copy: SEH