4835 Eriks Blvd - Inspection FormSump pumps
Foundation drains
Total
III
.--
Number
Discharged
Correctly
Incorrectly
Unknown
- -
Roof drains
4111- Cif of Ca
Residential Sanitary Sewer Service
Compliance Inspection
Dated I , 2 v ! Time
Name --.'_) ) r l4
Complance
No foundation drain connection
A i r No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Roots
PoorPipejoints
Mineral Deposits
Sag/Pipe Deflection
e
Damaged Pipe.
Transition , `s
7
4" to b" Transition:
White Copy: Property Owner
Disk #
p .1
-4-- 14--
• [ 0 a
• 4 pm
PID Number y�
House Number - ? Street Name
Alternative Mailing Address
Owner /Occupant Signature
Length of Service:
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
Service Lateral inspection Findings Number of stacks 4
Yellow Copy: City of Eagan
Record Number
Time
✓ '7
Phone /
`7 • o am
5 • Pm
Inspector Signature
7
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S. L. at
7 S i f ° f
Final Cleanout:
;1
Notes )
, 1ui/ /`;/17
/ / / : /(
I
7
e
Pink Copy: SEH