4638 Summit Pass - Inspection FormSump pumps
Y
Foundation drains
;i
Roof drains
411 City o[ Caftan
Residential Sanitary Sewer Service
Compliance Inspection
Date(ii
Alternative Mailing Address
4" to 6 "Transition:
White Copy: Property Owner
Time
Nam e �,,b /b ? 7 1 Disk ti
PID Number
House Number 3 Street Name
Owni:rlOccupant Signature
Phone C h i )
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Non - Compliance
0
O
O
O
0
2
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks 4 Entered S. at
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
Notes
4
:V
!' Time r
Insp ector Signature
Obstruction
Unable to push past
feet
o am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 4--)
'
Length of Service: �"j .
�
...�� ---- Final Cleanout: T
r r-
Yellow Copy: City of Eagan Pink Copy: SEH