4615 Stonecliffe Dr - Inspection FormCil of 1a a
Y � u
Residential Sanitary Sewer Service
Compliance Inspection
✓)
Date J t
Name "? :.� a - - � '
Time ,f. • m
p
Disk # [Ti
PID Number
House Number l fi Street Name
L
Alternative Mailing.Address Phone
4" to 6" Transition:
For information call 651.470.2788
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
D Sump pit not connected to
,sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
White Copy: Property Owner
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Li
I nspector Signature '.
Obstruction
Unable to push past
feet
Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
• O am
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
°-.
f
�` - ` "� f
"
i s
- f
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
.
MEM-
Foundation drains
Roof drains
Cil of 1a a
Y � u
Residential Sanitary Sewer Service
Compliance Inspection
✓)
Date J t
Name "? :.� a - - � '
Time ,f. • m
p
Disk # [Ti
PID Number
House Number l fi Street Name
L
Alternative Mailing.Address Phone
4" to 6" Transition:
For information call 651.470.2788
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
D Sump pit not connected to
,sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
White Copy: Property Owner
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Li
I nspector Signature '.
Obstruction
Unable to push past
feet
Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
• O am
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH