1354 St Andrew Blvd - Inspection Form4_: 1111 . 111. City of Flagg
Residential Sanitary Sewer Service
Compliance Inspection
Date , I) /72!/ )/
Name ./
PID Number
House Number ) Street Name
Alternative Mailing Address Phone
I /
/-,- (c.
Ow rer/Occupant Signature
For information call 651.470.2788
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
4" to 6" Transition:
White Copy: Property Owner
am
Time r • pm
Disk #
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
Service Lateral Inspection Findings 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
Record Number
Time
0 am
•
• 0 pm
Inspector Signature a
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
)
,,,,,---
6-'. ifi-- --' 4...."
i /
/:; 4 ''''? '""--I' 14
_..
Total
Sump pumps
/-----‘
— c
_ 0 !
( *c
' - r
- e "i 7
' '
Foundation drains
Mil
/ -7
BE
Roof drains
4_: 1111 . 111. City of Flagg
Residential Sanitary Sewer Service
Compliance Inspection
Date , I) /72!/ )/
Name ./
PID Number
House Number ) Street Name
Alternative Mailing Address Phone
I /
/-,- (c.
Ow rer/Occupant Signature
For information call 651.470.2788
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
4" to 6" Transition:
White Copy: Property Owner
am
Time r • pm
Disk #
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
Service Lateral Inspection Findings 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
Record Number
Time
0 am
•
• 0 pm
Inspector Signature a
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH