1365 Interlachen Dr - Inspection FormCity of to ii
Residential Sanitary Sewer Service
Compliance Inspection
Date ) I / ▪ /
Name r a ; , -. f ° T Disk #
PID Number
House Number
Alternat' Flailing Address
Compliance
O No foundation drain connection
O No roof drain connection
Y Sump pit not connected to
sanitary sewer
• Sump pump properly piped
O No sump pump
4" to 6" Transition:
!1 n
White Copy: Property Owner
Time
J Street Name
Ownerl0ccupant Signature
` 0 am
▪ Q pm
7
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
Phone
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
o am
•
• o pm
/
Inspector Signature N t f I '
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
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pump
Foundation drains
Roof drains
,
_
City of to ii
Residential Sanitary Sewer Service
Compliance Inspection
Date ) I / ▪ /
Name r a ; , -. f ° T Disk #
PID Number
House Number
Alternat' Flailing Address
Compliance
O No foundation drain connection
O No roof drain connection
Y Sump pit not connected to
sanitary sewer
• Sump pump properly piped
O No sump pump
4" to 6" Transition:
!1 n
White Copy: Property Owner
Time
J Street Name
Ownerl0ccupant Signature
` 0 am
▪ Q pm
7
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
Phone
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
o am
•
• o pm
/
Inspector Signature N t f I '
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