1567 Sherwood Way - Inspection Form 1
`e Residential Sewer Service Compliance Inspection
Date_ E1 /_4J) - Time - , e-_ O pm Record Number
O am
Name -`r Disk # Time O pm
PID Number
Street Name V-
House NumberT
4-Alternative Mailing Address Phone s'E
OwnerlOccupant Signature lnspdd or Signature
For information call. 651.470.2788
Compliance Non-Compliance Obstruction No Access
O No foundation drain connection O Clear water connections to Unable to push past No one in
O No roof drain connection sanitary sewer _feet O Access to service
O Service lateral defects lateral needed
O Sump pit not connected to O Defective manholes
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
Service Lateral Inspection Findings Number of stacks Entered S. L. at
Roots -
PoorPipeJoints _
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe _
Transition
4" to 6"Transition: Length of Service: Final Cleanout:
Notes
•
Number Total Correctly Incorrectly Unknown
2~r
Sump pumps
Foundation drains T -
Roof drains = 1 • i I
~J
White Copy: Property Owner Yellow Copy: Ciry of Eagan Pink Copy: SEH