1495 Sherwood Way - Inspection Form
Residential Sanitary Sewer~Service.
City E Ir Compliance Inspection
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Date 1 1 )i` Time. '~rj pm Record Number
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Name ~ ~ r` %s=~~' bisk # Time - ~ ~ P.
PID Number `
Street Name i~%} ter`"
1-louse Number
Alternative Mailing-Address Phone
j Ownerl'Occupant Signature Inspector Signature
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For informaidon call 651.470.2788
Compliance Non-Compliance Obstruction No Access
f No foundation drain connection O Clear water connections to Unable to push past O No one in
No roof drain connection sanitary sewer -feet O Access to service
O Service lateral defects lateral needed
~ - Sump pit not connected to O Defective manholes
sanitary sewer O Inspection
O Sump pump connected to sanitary refused
Sump pump properly piped sewer
O No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number, of stacks Entered S. L. at~
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition: Length of Service: f ? y - . 'r,= Final Cleanout:
Notes
Number Discharged
Total Correctly Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SE14