1680 Sherwood Way - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
f �
Date, 1 " 1
Name
PID Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped 7,
O No sump pump
Service Lateral Inspection Findings
2' f r 4' 7
4" to 6 "Transition:
White Copy: Property Owner
7
Time ! fik 0 pm
Disk#
Street Name
OwnerlOccupaitttignature
Number of stacks
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
0 Defective manholes
' Sump pump connected to sanitary
1C'i1 r sewer
O Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
/
Phone
Length of Service: ,` ! •
f f
S
d �
• tiw, ' c am
Time •' o pm
Inspector Signature
For information call 651.470.2788
.;
Entered S L at 5 ;
Final Cleanout:
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
2
Sag /Pipe Deflection ' ;(- --
Damaged Pipe
Transition , >-
Pink Copy: SEH
Number Discharged
Unknown
Notes
, .:
� /( 1 (; l � - �
�.
../ r i' n
Total
Correctly
Incorrectly
Sump pumps
fi
Foundation drains
Roof drains
`,! ' ... . J j. � " J o d / rte / N � - . -
Residential Sanitary Sewer Service
Compliance Inspection
f �
Date, 1 " 1
Name
PID Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped 7,
O No sump pump
Service Lateral Inspection Findings
2' f r 4' 7
4" to 6 "Transition:
White Copy: Property Owner
7
Time ! fik 0 pm
Disk#
Street Name
OwnerlOccupaitttignature
Number of stacks
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
0 Defective manholes
' Sump pump connected to sanitary
1C'i1 r sewer
O Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
/
Phone
Length of Service: ,` ! •
f f
S
d �
• tiw, ' c am
Time •' o pm
Inspector Signature
For information call 651.470.2788
.;
Entered S L at 5 ;
Final Cleanout:
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
2
Sag /Pipe Deflection ' ;(- --
Damaged Pipe
Transition , >-
Pink Copy: SEH