1504 Thomas Lane - Inspection FormSump pumps
Foundation drains
Roof drains
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City at an
Residential Sanitary Sewer Service
Compliance Inspection
0 :7
Date .1 Time
'
Name
,(` Disk #
PID Number
House Number / — Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
49 Sump pit not connected to
; sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
Service Lateral Inspection Findings
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OwnerlOccupant Signature,..,
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Oni Pm
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
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
Time
am
•
• 0 pm
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Phone /..""
Obstruction
Unable to push past
feet
Entered S L at
Inspector Signature
Final Cleanout:
Notes
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
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Yellow Copy: City of Eagan Pink Copy: SEH