1512 Pinetree Tr - Inspection FormSump pumps
Foundation drains
Roof drains
)
y J
City of Ea n
Residential Sanitary Sewer Service
Compliance Inspection
Date 1
Name
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
} sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Total
Time " rte • 'O p m
{
Disk #
PO Number
House Number , Street Name
Owner /Occupant Signature
MOM
Alternative Mailing Address Phone r� .. w • w ] - 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:
Notes
Correctly Incorrectly Unknown , y
Number Discharged
Record Number. I
Time
J �4 y • A'/
Obstruction
Unable to push past
feet
Entered S.L. at
Inspector Signature
Final Cleanout:
•
0 am
• 0 pm
3 !
10 C7C)e-3
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
-
Yellow Copy: City of Eagan Pink Copy: SEH