1382 St Andrew Blvd - Inspection Form4 City of Fa an
Residential Sanitary Sewer Service
Compliance Inspection
'f' } s.
Date ;° i 1; 1 f'
Name Disk#
PID Number
House Number , . C- 3 r;" Street Name
Alternative Mailing Address Phone /,-, .. )
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6 "Transition:
White Copy: Pr oper ty Owner
Time • o pm
Owner /Occupant Signature
J-LD
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:
Yellow Copy: City of Eagan
Record Number - °- C' 7"
Time
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
o em
o pm
inspector Signature
- f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered 5 L.at
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
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F
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Total
Sump pumps
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Foundation drains
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Roof drains
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4 City of Fa an
Residential Sanitary Sewer Service
Compliance Inspection
'f' } s.
Date ;° i 1; 1 f'
Name Disk#
PID Number
House Number , . C- 3 r;" Street Name
Alternative Mailing Address Phone /,-, .. )
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6 "Transition:
White Copy: Pr oper ty Owner
Time • o pm
Owner /Occupant Signature
J-LD
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:
Yellow Copy: City of Eagan
Record Number - °- C' 7"
Time
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
o em
o pm
inspector Signature
- f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered 5 L.at
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH