1451 Wellington Way - Inspection FormCif ohIa afl
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date
1�
)
�
Name :, / 7/6,-:-.`5 f ,-.'c_',14?`. Disk#
RID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
V Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
) Street Name
I • >o am
Time I a,
p
1 / jj l t J
Owner /Occupant Signature
-co
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
Obstruction
Unable to push past
feet
Entered S L at
Final Cleanout:
• o am
• o Pm
Inspector Signature ' ) - f � / rte
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
!
Number Discharged
Notes
I- , - �
- -' _:� +/ - � ' -r / ~ ? _ -• -.
- �2< ' 2 ._' ; ' ---
' /1 - 2 -- _= %) /" 7 �. 1 --
't/ '
1' '----7 . ..- :..:.,,1
W _. - 1 ,, %� 1, ry ,
Total
Correctly
Incorrectly Unknown
Sump pumps
f
v
Foundation drains
Roof drains
t ✓ '�
Cif ohIa afl
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date
1�
)
�
Name :, / 7/6,-:-.`5 f ,-.'c_',14?`. Disk#
RID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
V Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
) Street Name
I • >o am
Time I a,
p
1 / jj l t J
Owner /Occupant Signature
-co
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
Obstruction
Unable to push past
feet
Entered S L at
Final Cleanout:
• o am
• o Pm
Inspector Signature ' ) - f � / rte
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
!