1307 St Andrew Blvd - Inspection FormResidential Sanitary Sewer Service
, City of Ea as Compliance Inspection
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Dater/ Jf 11 / i Time
Name ,
House Number
Alternative Mailing Address
O No sump pump
4" to 6" Transition:
Disk # 7
PID Number
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
White Copy: Property Owner
t ?f/ p, am
•
pm
Street Name
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 "' I'
o am
Time • o pm
J
Phone
Obstruction
Unable to push past
feet
Final Cleanout:
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
Pink Copy: SEH
Number Discharged
N tes
e_' - i7,1 r'-,7' ><' ,/,-'--;----,
l r e ___, : ,,. - �-
2 i y` _
i i f � `` � ✓
..i- r ,'/ : _ :2(
Total
Correctly
Incorrectly
Unknown
Sump pumps
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- -? �
_ __ '
, O K
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t4K
,
Foundation drains
Roof drains
Residential Sanitary Sewer Service
, City of Ea as Compliance Inspection
}} r)
Dater/ Jf 11 / i Time
Name ,
House Number
Alternative Mailing Address
O No sump pump
4" to 6" Transition:
Disk # 7
PID Number
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
White Copy: Property Owner
t ?f/ p, am
•
pm
Street Name
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 "' I'
o am
Time • o pm
J
Phone
Obstruction
Unable to push past
feet
Final Cleanout:
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
Pink Copy: SEH