1393 Interlachen Dr - Inspection FormCity of hap
Residential Sanitary Sewer Service
Compliance Inspection
Date ) (7 . 1 j/ )( •
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
'0 Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6"Transition:
White Copy: Property Owner
(") 7/
Oiam
Time • Of pm
Name / )) 7 Disk #
PID Number
House Number I Street Name
0 Signature
■YM
'7' 241 Alternative MailingAddress Phone 7.) (1)
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
iff
•
' 0 am
• 0 pm
1( 4
Inspector Signature J ; \ IV,
v
Obstruction
Unable to push past
feet
Entered St at
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
"17
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
1 /
Foundation drains
Roof drains
City of hap
Residential Sanitary Sewer Service
Compliance Inspection
Date ) (7 . 1 j/ )( •
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
'0 Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6"Transition:
White Copy: Property Owner
(") 7/
Oiam
Time • Of pm
Name / )) 7 Disk #
PID Number
House Number I Street Name
0 Signature
■YM
'7' 241 Alternative MailingAddress Phone 7.) (1)
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
iff
•
' 0 am
• 0 pm
1( 4
Inspector Signature J ; \ IV,
v
Obstruction
Unable to push past
feet
Entered St at
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
"17