4295 Amber Dr - Inspection Form
Residential Sanitary Sewer Service
City 0113PH
Compliance Inspection
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Date-1 1 Time ~s o pm Record Number t
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Name I'QDisk#t )j T
ime _O PM
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PID Number
Street Name
House Number /-Os-
Alternative Mailing Address Phoned
71. ,
OwnerlOccupant Signature ' frrspector Signature
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Compliance Non-Compliance Obstruction No Access
No foundation drain connection O Clear water, connections to Unable to push past O No one in
sanitary sewer, feet
i' No roof drain connection O Access to service
O Service lateral defects lateral needed
O Sump pit not connected to O Defective manholes
sanitary sewer O Sump pump connected to sanitary O Inspection
O Sump pump properly piped sewer, refused
No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number- of stacks Entered S. L at tt'';L ('a
Roots 75 5r ~
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection ~Il
Damaged Pipe
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Transition C j f w I
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4" to 6" Transition: Length of Service: Final Cleanout:
Notes
Number Discharged
Total Correctly incorrectly Unknown
Sump pumps
Foundation drains
s
Roof drains
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH