1335 St Andrew Blvd - Inspection FormCity of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date , f ! / / . /
Name
PID Number
House Number
Alternative Mailing Address
b r
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
• �. 2) am
Time i q' pm
f . Street Name
Owner /Occupant Signature
Disk #rTi ....H
-m
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
L - 1 erg
77 T ... � : J ? I a r`
Phone > 17 - ) L -° w )
r , .
For information call 651.470.2788
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Notes
�.,
Record Number
Time
Obstruction
Unable to push past
feet
Inspector Signature it
Final Cleanout:
J
O am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
4
r
-3
, LJ [2
_ /
/71`4
_
Foundation drains
t
i
Roof drains
.F]
City of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date , f ! / / . /
Name
PID Number
House Number
Alternative Mailing Address
b r
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
• �. 2) am
Time i q' pm
f . Street Name
Owner /Occupant Signature
Disk #rTi ....H
-m
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
L - 1 erg
77 T ... � : J ? I a r`
Phone > 17 - ) L -° w )
r , .
For information call 651.470.2788
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Notes
�.,
Record Number
Time
Obstruction
Unable to push past
feet
Inspector Signature it
Final Cleanout:
J
O am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH