1380 Grace Dr - Inspection FormSump pumps
Foundation drains
Roof drains
.city or Ea pa
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
House Number
Roots
Poor Pipejoints
Mineral Deposits
273/
4" to 6" Transition:
PIE) Number
Alternative fling Address
Sump pit not connected to
sanitary sewer
% V . Sump pump properly piped
0 No sump pump
White Copy: Property Owner
" ' y am • 3( am
Time / • _— V Pm
r
Disk # /)
Street Name
Owner /Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Service Lateral Inspection Findings
Total
Correctly
Sag /Pipe Deflection
Damaged Pipe
Transition
(9
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
Length of Service: -.t
Number Discharged
Incorrectly Unknown
,4
Phone
J
Record Number L'
L
Time • f o pm
Obstruction
Unable to push past
feet
2
Inspect'o'r Signature
For information call 651.470.2788
Final Cleanout: --
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S L at 'f`� /F = �s
N otes
f J•._ /l
g
.. t r . S" ;;_ �2 � �' " , � i ) =..
/a
Li r
�y i
Yellow Copy: City of Eagan Pink Copy: SEH
eta
1