1501 Pinetree Pass - Inspection Form4 111. Residential Sanitary Sewer Service
City of kali Compliance Inspection
Date
Name i /�
PID Number
1 .P f . a:
House Number _ -_ ; ( ' ,{ ; Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6" Transition:
•
,
White Copy: Property Owner
} J R,_r' qq am
Time k5 pm
Disk #
Owner /Occupant Signature
Non — Compliance
O
O
O
O
O
m
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
[_ILI L I Time
Phone -22 . )
Obstruction
Unable to push past
feet
Final Cleanout:
• oem
• o pm
Inspector Signature ai)
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
7 l
Number
Correctly
Discharged
Incorrectly Unknown
Notes
>v. ,_ ..; . .>
/ r ,, � e .' S ?. -r t' fj J
A'_".. '< ri, -- _e„..." k ' 1
Total
Sump pumps
Foundation drains
NEM
Roof drains
OEM
J °
4 111. Residential Sanitary Sewer Service
City of kali Compliance Inspection
Date
Name i /�
PID Number
1 .P f . a:
House Number _ -_ ; ( ' ,{ ; Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6" Transition:
•
,
White Copy: Property Owner
} J R,_r' qq am
Time k5 pm
Disk #
Owner /Occupant Signature
Non — Compliance
O
O
O
O
O
m
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
[_ILI L I Time
Phone -22 . )
Obstruction
Unable to push past
feet
Final Cleanout:
• oem
• o pm
Inspector Signature ai)
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
7 l