4668 Pinetree Curve - Inspection FormCity of Calm
Residential Sanitary Sewer Service
Compliance Inspection
Date)
)(
Name )
ND Number
House Number
Alternative Mailing Address
)
/
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
4 Sump pump properly piped
O No sump pump
Service Later al Inspection Findings Number of stacks
4" to 6" Transition:
White Copy: Property Owner
AP' A
4 3 am
Time • 8
pm
Disk #________
Street Name
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
o arn
•
• 0 Pm
) ) . . ▪ ".
Phone )
,
inspector Signature \
I c— r
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S Lat
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
' /
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...?:
Foundation drains
Roof drains
i
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v
City of Calm
Residential Sanitary Sewer Service
Compliance Inspection
Date)
)(
Name )
ND Number
House Number
Alternative Mailing Address
)
/
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
4 Sump pump properly piped
O No sump pump
Service Later al Inspection Findings Number of stacks
4" to 6" Transition:
White Copy: Property Owner
AP' A
4 3 am
Time • 8
pm
Disk #________
Street Name
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
o arn
•
• 0 Pm
) ) . . ▪ ".
Phone )
,
inspector Signature \
I c— r
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S Lat
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH