1407 Rebecca Lane - Inspection FormSump pumps
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Foundation drains
Roof drains
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4 111. City of hap
Residential Sanitary Sewer Service
Compliance Inspection
J i f
Date J , / I Time,
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Proper ty Owner
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• 'O
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Name 6 ='> I r �� Disk # r
PID Number
House Number ) / Street Name
Alternati
OwnerlO glipant Signature
C
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
Transition
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Length of Service: Final Cleanout:
• O am
• Opm
e Mailing Address Phone /-"<<}: C > r
Inspector Signature ,\j5/) ✓Jf
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
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Pink Copy: SEH