4622 Stonecliffe Dr - Inspection FormCity of E,a ftao
Residential Sanitary Sewer Service
Compliance Inspection
Date i P 1.�'`/i it'
)
Name i *:
PO Number
House Number
r J ,
lei` >. 11i rri
Owner /Occupant Signature
Compliance
O No foundation drain connection
�p O- No roof drain connection
b Sump pit not connected to
sanitary sewer
0/Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6 "Transition:
White Copy: Property Owner
Time . - •�J o am
• pm
Disk #
Street Name
Number of stacks
Length of Service:
r r
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
Yellow Copy: City of Eagan
Record Number
Time
Alternative Mailing Address Phone -
inspector
Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L. at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
O am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
t , °; l
t i
/� jj " / 9 // t.4.:1`:17:
.
Total
Sump pumps
Foundation drains
Roof drains
+r, ''
MIN
City of E,a ftao
Residential Sanitary Sewer Service
Compliance Inspection
Date i P 1.�'`/i it'
)
Name i *:
PO Number
House Number
r J ,
lei` >. 11i rri
Owner /Occupant Signature
Compliance
O No foundation drain connection
�p O- No roof drain connection
b Sump pit not connected to
sanitary sewer
0/Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6 "Transition:
White Copy: Property Owner
Time . - •�J o am
• pm
Disk #
Street Name
Number of stacks
Length of Service:
r r
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
Yellow Copy: City of Eagan
Record Number
Time
Alternative Mailing Address Phone -
inspector
Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L. at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
O am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH