1521 Sherwood Way - Inspection Form='-=
Number
Correctly
Discharged
Incorrectly
Unknown
Notes ; 1-T -ti
Total
Sump pumps
it is -
74J,!
f ( _ 7 '=
o
Foundation drains
r
I
Roof drains
Ell
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name .
y' d
PID Number
House Number ! /7
Alternative Mailing Address
Compliance
b No foundation drain connection
r�
S No roof drain connection
Sump pit not connected to
' sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
'
} /
Roots _ J-/ ` '
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition I...%
4" to b" Transition:
I 1
1
White Copy: Property Owner
} • G am
Time z _._ • p
Disk #
Street Name
wnerlOccupant Signature
Number of stacks
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
i 1. /
Length of Service: ` -7
Yellow Copy: City of Eagan
Record Number
",3 bam
Time / • ;-( / 'O pm
Phone ! 1 d. -
~ m - insp`dor Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S . at
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Final Cleanout: r �--
Pink Copy: SEH