4623 Pinetree Cur - Inspection FormCity ofFa fl
Residential Sanitary Sewer Service
Compliance Inspection
Date d �'�1 ff`
Name
PID Number
%/
House Number �` _ Street Name
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
t sanitary sewer
bi Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Time
Disk#
am
A
Pm
9
Alternative Mailing Address
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
Record Number
Time
Phone P ,71 4 7
inspector Signature
For information call 65 1.470.2788
Obstruction
Unable to push past
feet
O am
•
O Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH
Total
Notes
P _
;:'
/11 ..,-.""'
/
' . t f �
Mai"
% /1
�
1
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
----
Roof drains
?
City ofFa fl
Residential Sanitary Sewer Service
Compliance Inspection
Date d �'�1 ff`
Name
PID Number
%/
House Number �` _ Street Name
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
t sanitary sewer
bi Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Time
Disk#
am
A
Pm
9
Alternative Mailing Address
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
Record Number
Time
Phone P ,71 4 7
inspector Signature
For information call 65 1.470.2788
Obstruction
Unable to push past
feet
O am
•
O Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH