1485 Pinetree Pass - Inspection FormSump pumps
t�
Foundation drains
Roof drains
4 1. Residential Sanitary Sewer Service
City of Non Compliance Inspection
Date f A 1 --'i / /(../
Name
PID Number
House Number ) ^ Street Name
Phone -D yf. /�t L' jv3
Alternative Mailing Address
IL'
am
Time I • ' pm
Disk # ED -E
Owner /Occupant Signature
For information call 651.470.2788
Compliance Non - Compliance
O No foundation drain connection 0 Clear water connections to
sanitary sewer
O Service lateral defects
O Sump pit not connected to
0 Defective manholes
sanitary sewer /;; (;
O Sump pump connected to sanitary
W Sump pump properly piped sewer
O No sump pump 0 Flexible sump pump piping
O No roof drain connection
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Total Correctly
Length of Service: Final Cleanout:
Number Discharged
Incorrectly Unknown
Record Number `�
Entered S. L at
�1
0 am
•
Time _ � p pm
Obstruction
Unable to push past
feet
Notes
Inspector Signature >i) ) l� fl J
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH