1480 Pinetree Pass - Inspection Form4 111*
City of Eapn
Residential Sanitary Sewer Service
Compliance Inspection
) I /
Date 1 1/
Name )
e Disk #
PFD Number
)
House Number Street Name
Alternative Mailing Address
,L
1 ;I A
7/1
OwiriejlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Mope' ty Owner
am
Time •p
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
Obstruction
Unable to push past
feet
•
•
ITZ2
Phone (.";-, /
o am
0 pm
<L1,
Inspector Signature )
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH
Number Discharged
Notes
. i i ' .. ... ).----,- ,-----.:,-
_..., ,
• / i i
i
.......„-•! -,, .i ,-,.. , /2 , I ) __,...)_
c _..---' .,-:. ,---,,,.. c. <: g-- .•_:_ 7 "
, ..... R, . I ....,' -
- ' •,' 7 --- tr. - 7' . ' '';) /// ) (r ...- ? : c-- -- / -7— :
_••,) /." ___..) __)//' .,---,
..,.....-- ...:••-•;_ ,..-----7-z... ; ,, /.:....--.-?..- .___,....._/
'./"...-- ,z _ • ,
Total •
Correctly
Incorrectly
Unknown
Sump pumps
41
Foundation drains
Roof drains
..-,
7.-
1 ......,...----
. /
4 111*
City of Eapn
Residential Sanitary Sewer Service
Compliance Inspection
) I /
Date 1 1/
Name )
e Disk #
PFD Number
)
House Number Street Name
Alternative Mailing Address
,L
1 ;I A
7/1
OwiriejlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Mope' ty Owner
am
Time •p
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
Obstruction
Unable to push past
feet
•
•
ITZ2
Phone (.";-, /
o am
0 pm
<L1,
Inspector Signature )
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH