4733 Westminster Cir - Inspection FormSump P s P
Spumps
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-1'
C.
Foundation drains
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Roof drains
City oi Fapi
Residential Sanitary Sewer Service
Compliance Inspection
Dated
Name° a� `/ ✓f� i } �� { J ;Disk #
PID Number
House Number L-- 2 Street Name
7
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
.3) oam
Time l c • pm
lwnerlOccupant-Signature
8
Service Lateral Inspection Findings Number of stacks
Roots
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
Record Number
Phone
•
7 .1 Time •
inspector Signature
Obstruction
Unable to push past
feet
Entered S.L. at ; -,7
o am
bi
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Pr operty Owner
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout: - ' ° �_
Total
Number Discharged
Correctly Incorrectly
Unknown
Notes
y , t
Pink Copy: SEH