1507 Thomas Lane - Inspection FormSump pumps
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Foundation drains
Roof drains
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4111 City of • �3a as
Residential Sanitary Sewer Service
Compliance Inspection
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Date i / / 'f / i
) • /? am
Time l .• .p pm
Name 4 .rc ) Y / ' i ! Disk # ri -- 1
PID Number
1 '' - Street Name ) i"). ''C'� ]
House Number r .
�- i
Alternative Mailing Address
I
`Owner /Occupant 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
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to b "Transition:
White Copy: Propel ty Owner
Total
Length of Service:
Number Discharged
Record. Number
N otes
Correctly Incorrect) Unknown f ~
Y Y
Time
y !
Phone t I
Obstruction
Unable to push past
feet
Poor Pipejoints
O am
•
• o pm
r
For information call 651.470.2788
Final Cleanout:
Service Lateral Inspection Findings Number. of stacks Entered S L at
Roots
! ! � � 1 Y
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/ 1
�. 0 ,
=rr
Yellow Copy: City of Eagan Pink Copy: SEH