1367 St Andrew Blvd - Inspection Form
Residential Sanitary Sewer Service
. 4-0. cit, I. E
Compliance Inspection
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Date' Time pm Record Number
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Name r J / / Disk#
PID Number
House Number Street Name "
Alternative Mailing Address phone
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OwnerlOccupont Signature Inspector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
V No foundation drain connection O Clear water connections to Unable to push past O No one in
AI sanitary sewer feet.
9 No roof drain connection O Access to service
XV O Service lateral defects lateral needed
k? Sump pit not connected to O Defective manholes
f sanitary sewer O Inspection
O Sump pump connected to sanitary refused
O Sump pump properly piped sewer
O No sump pump O Flexible sump pump piping
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Service Lateral Inspection Findings Number of stacks Entered S,L,at --<-4 -
Roots
Poor-Pipe joints
Mineral Deposits
Sag/Pipe Deflection _
Damaged Pipe
Transition
4" to 6"Transition: Length of Service: _.~Z, Final Cleanout:
Number Discharged Notes
Total Correctly Incorrectly Unknown
IIA Z'
1
Sump pumps Vii= r S , f
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Foundation drains
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1
Roof drains
V IMte Copy: Property OwnCr Yellow Copy: City of Eagan Pink Copy: SEH