4640 Pilot Knob Rd - Inspection FormCity of Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date�)
am
Time • 7S p
Name f t } Disk # Cj1
1
PID Number
4" to 6 " Transition:
White Copy: Property Owner
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
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
Obstruction
Unable to push past
feet
• o am
• o pm
House Number ) ! ( Street Name r fr' ' , )0 )
Alternative Mailing Address Phone / ,m. ______.,�• - �.�,
Inspector Signature
For information call 651.470.2788
Final Cleanout:
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: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
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r
� � : !.; i .. `.�"° l�`- 1,4/...71-
1
) ' J^ �` a
Total
Sump pumpe
s l
°'`'
Foundation drains
Roof drains
City of Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date�)
am
Time • 7S p
Name f t } Disk # Cj1
1
PID Number
4" to 6 " Transition:
White Copy: Property Owner
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
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
Obstruction
Unable to push past
feet
• o am
• o pm
House Number ) ! ( Street Name r fr' ' , )0 )
Alternative Mailing Address Phone / ,m. ______.,�• - �.�,
Inspector Signature
For information call 651.470.2788
Final Cleanout:
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: SEH