4876 Steeplechase Way - Inspection FormCity of Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 k
Name L i / :� 1
O
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
White Copy: Property Owner
-1
40,---)/1:,) 0a
Time • Pm
Disk # I I 1
PID Number
House Number ; Street Name
Alternative Mailing Address
7 I
L . v
OwnerlOccupant Signature
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
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
7
• 0 a
• O Pm
Phone _. c.0
inspector Signature ` 1
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
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Total
Sump pumps
Sum um s
l
Foundation drains
----
Roof drains
...,-).
V I
City of Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 k
Name L i / :� 1
O
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
White Copy: Property Owner
-1
40,---)/1:,) 0a
Time • Pm
Disk # I I 1
PID Number
House Number ; Street Name
Alternative Mailing Address
7 I
L . v
OwnerlOccupant Signature
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
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
7
• 0 a
• O Pm
Phone _. c.0
inspector Signature ` 1
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH