1468 Pinetree Pass - Inspection FormCity of hatan
Residential Sanitary Sewer Service
Compliance Inspection
)
Date / ;
Name?" , ' Disk #
I-louse Number
Altecnative 14ilingAddr•ess
i
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T I, .,, , h I / ''‘ „,---'''''
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
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Pi opetty Owner
,.••• /I)
r
Time ,.
• - o am
( 0 pm
PID Number
Owner/Occupant Signature
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:
MEM
Yellow Copy: City of Eagan
Record Number
/
) Street Name ) • —1")
Time
1
Phone (...;-;
Entered SL at
'Inspector Signature
Obstruction
Unable to push past
feet.
Final Cleanout:
Oam
•
• 0 pm
A , 46 , -/A r) 7 v
For information call 651.470.2788
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
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
1
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-... .
Total
Sump pumps
MEI
Foundation drains
1111111111111
Roof drains
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City of hatan
Residential Sanitary Sewer Service
Compliance Inspection
)
Date / ;
Name?" , ' Disk #
I-louse Number
Altecnative 14ilingAddr•ess
i
j \ I
i \ !\ 1 ,,,, ,--•
-1 \ —
T I, .,, , h I / ''‘ „,---'''''
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
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Pi opetty Owner
,.••• /I)
r
Time ,.
• - o am
( 0 pm
PID Number
Owner/Occupant Signature
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:
MEM
Yellow Copy: City of Eagan
Record Number
/
) Street Name ) • —1")
Time
1
Phone (...;-;
Entered SL at
'Inspector Signature
Obstruction
Unable to push past
feet.
Final Cleanout:
Oam
•
• 0 pm
A , 46 , -/A r) 7 v
For information call 651.470.2788
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
Pink Copy: SEH