1490 Pinetree Tr - Inspection Formo
41111
Cil oi� Fa
Y p
Residential Sanitary Sewer Service
Compliance Inspection
Date
r:g
t�
Name s ,
PID Number
House Number )c:..• -f"
Alternative Mailing Address
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
N.t
io Sump pump properly piped
O No sump pump
Time
Service Lateral Inspection Findings
White Copy: Property Owner
C'.) / ! Disk
Street Name
Owner/Occupant Signature
O
O
O
O
O
am
pm
For information call 651.470.2788
Non - Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
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 . 1
Time
Phone ) r f °`r -
Obstruction
Unable to push past
feet
•
O am
O pm
Inspector Signature Ai
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S,L.at
Pink Copy: SEH
�•� �g f,/
Number
Correctly
Discharged
Incorrectly Unknown
Notes
^
�W, ;. -. - w> r a'
L.
,. {�
' r i � a L
Total
Sump pumps
A
Foundation drains
Roof drains
-
o
41111
Cil oi� Fa
Y p
Residential Sanitary Sewer Service
Compliance Inspection
Date
r:g
t�
Name s ,
PID Number
House Number )c:..• -f"
Alternative Mailing Address
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
N.t
io Sump pump properly piped
O No sump pump
Time
Service Lateral Inspection Findings
White Copy: Property Owner
C'.) / ! Disk
Street Name
Owner/Occupant Signature
O
O
O
O
O
am
pm
For information call 651.470.2788
Non - Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
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 . 1
Time
Phone ) r f °`r -
Obstruction
Unable to push past
feet
•
O am
O pm
Inspector Signature Ai
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S,L.at
Pink Copy: SEH
�•� �g f,/