1664 Sherwood Way - Inspection FormSump pumps
Foundation drains
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Roof drains
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411111111 Cif of Ea ui
Residential Sanitary Sewer Service
Compliance Inspection
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Date ' f � , ,, f /
Name s .
PID Number
House Number vG f Street Name . "Ck Aft.i /1
Alternative MailingAddress
For information call 651.470.2788
Compliance
f
1`a No foundation drain connection
/
; p No roof drain connect n
44
Sump pit not connected to
"sanitary sewer
`b\ Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
White Copy: Property Owner
6 i
� �'�.� Disk #
Time o arr
• � i - 61 Pm
Owner /Occupant Signature
Total
0
0 /
Damaged Pipe
i
Transition_' / /
j J( Iwo
4" to 6" Transition:
Non- Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
• 0 Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
Number Discharged
Correctly Incorrectly Unknown
Length of Service: �
Notes
76 icy-
f •
Obstruction
Unable to push past
feet
Record Number
Time ' •
•
S , -.
Phone (.,
� 3
Inspector Signature
o am
p m
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S. L at
Final Cleanout: ,?
Yellow Copy: City of Eagan Pink Copy: SEH