4763 Cypress Pt - Inspection Form4. city or Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date / r I I
Name ,2 �1 / �I' Disk#
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
S i' No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Q._.�6. o am
Time ) • • ' pm
Street Name
OwnerlOc pant Signature
For information call 651.470.2788
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet.
Final Cleanout:
q am
•
Time • q pm
Phone . 7-7 J °
O Inspection
refused
Inspector Signature 1 )
No Access
O No one in
O Access to service
lateral needed
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
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Total
Sump pumps
s
�' _ !
r-,
i ( ,
j .- °
1 � , '
Foundation drains
Roof drains
t i' s
4. city or Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date / r I I
Name ,2 �1 / �I' Disk#
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
S i' No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Q._.�6. o am
Time ) • • ' pm
Street Name
OwnerlOc pant Signature
For information call 651.470.2788
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet.
Final Cleanout:
q am
•
Time • q pm
Phone . 7-7 J °
O Inspection
refused
Inspector Signature 1 )
No Access
O No one in
O Access to service
lateral needed
Pink Copy: SEH