1352 Interlachen Dr - Inspection FormCity of Egan
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 l 1 1 dr •
Name
PID Number
House Number l 7' Street Name
Alternative Mailing Address
•
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
c k 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
) • �l am
Time J • pm
Disk #I
J
For information call 651.470.2788
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
Number of stacks Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
-LE
Record Number
Time
• 0 a
• O pm
Phone r, l
Obstruction
Unable to push past
• feet
Inspector Signature dA it �}
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
Number Discharged i
Total
Correctly
Incorrectly
Unknown"
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Sump pumps
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Foundation drains
.,
Roof drains
City of Egan
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 l 1 1 dr •
Name
PID Number
House Number l 7' Street Name
Alternative Mailing Address
•
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
c k 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
) • �l am
Time J • pm
Disk #I
J
For information call 651.470.2788
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
Number of stacks Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
-LE
Record Number
Time
• 0 a
• O pm
Phone r, l
Obstruction
Unable to push past
• feet
Inspector Signature dA it �}
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH