4624 Pinetree Cur - Inspection Form4111
City f Ea
Y as �
Residential Sanitary Sewer Service
Compliance Inspection
)}1 )
Date l i l / l / !7 1
• L
Name ..
PID Number
Alternative Mailing Address
r' 4.1 .. '.0 Disk #
o
Compliance
O No foundation drain connection
O No roof drain connection
C Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to b" Transition:
White Copy: Property Owner
•/n am
•
Time, • pm
ccupant Signature
TPPIIM
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
Service Lateral inspection Findings Number of stacks
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
House Number Street Name
LiTime
�
Phone
For information call 651 .470.2788
Obstruction
Unable to push past
feet
Entered S L at
Notes
/
—
inspector Signature /1,";
3 '
Final Cleanout:
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
V
Foundation drains
Roof drains
J ai
-.
4111
City f Ea
Y as �
Residential Sanitary Sewer Service
Compliance Inspection
)}1 )
Date l i l / l / !7 1
• L
Name ..
PID Number
Alternative Mailing Address
r' 4.1 .. '.0 Disk #
o
Compliance
O No foundation drain connection
O No roof drain connection
C Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to b" Transition:
White Copy: Property Owner
•/n am
•
Time, • pm
ccupant Signature
TPPIIM
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
Service Lateral inspection Findings Number of stacks
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
House Number Street Name
LiTime
�
Phone
For information call 651 .470.2788
Obstruction
Unable to push past
feet
Entered S L at
Notes
/
—
inspector Signature /1,";
3 '
Final Cleanout:
o am
•
• o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH