4765 Pilot Knob Rd - Inspection Form40. City of Ea a
Residential Sanitary Sewer Service
Compliance Inspection
Date) 1 ! t l 1(_J
Name
4" to 6" Transition:
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
:-' j
fS •- am
Time ( • O pm
Disk #
PID Number
House Number --- ° / i%n•. ' Name
Alternative Mailing Address
OwnerlOccupant Signature
Compliance
O No foundation drain connection
-m-
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone /. )
Obstruction
Unable to push past
feet
Final Cleanout:
-, c:;' _
-
• O am
• o pm
Inspector Signature i , a:.,) ') a? y
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SE H
Notes
Number
Discharged
Total Correctly
Incorrectly
Unknown
Sump pumps
ral M ill
Foundation drains
Roof drains
--
40. City of Ea a
Residential Sanitary Sewer Service
Compliance Inspection
Date) 1 ! t l 1(_J
Name
4" to 6" Transition:
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
:-' j
fS •- am
Time ( • O pm
Disk #
PID Number
House Number --- ° / i%n•. ' Name
Alternative Mailing Address
OwnerlOccupant Signature
Compliance
O No foundation drain connection
-m-
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone /. )
Obstruction
Unable to push past
feet
Final Cleanout:
-, c:;' _
-
• O am
• o pm
Inspector Signature i , a:.,) ') a? y
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SE H