1594 Sherwood Way - Inspection Form 3Residential Sanitary Sewer Service
4 an Compliance inspection
Date ,s
Name f
P]D Number
1
o pliance
igik No foundation drain connection
d Sump pit not connected to
sanitary sewer
No roof drain connection
Sump pump properly piped
0 No sump pump
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 'r.
4" to 6 "Transition:
White Copy: Property Owner
Time
Disk #
House Number ) .77 Street Name
Owro`IOccupant Signature
Service Lateral Inspection Findings
Roots C
Poor Pipe Joints
am
0 pm
Record Number ._.�
Time
/V am
0 pm
Alternative Mailing Address Phone
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
/) Number of stacks Entered S L. at
f
J Y y - f
1 1 2 ..�_a! <.J )
/ 2?.
Length of Ser vice:
Yellow Copy: City of Eagan
r
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
r
1
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
., ) 1
1 , � -) ' �` c_
�.
1
_ -� (- ,
/J � n
T
Sump pumps
,. r
" , '
- ' �
J'
i ,s7
Foundation drains
Roof drains
Residential Sanitary Sewer Service
4 an Compliance inspection
Date ,s
Name f
P]D Number
1
o pliance
igik No foundation drain connection
d Sump pit not connected to
sanitary sewer
No roof drain connection
Sump pump properly piped
0 No sump pump
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 'r.
4" to 6 "Transition:
White Copy: Property Owner
Time
Disk #
House Number ) .77 Street Name
Owro`IOccupant Signature
Service Lateral Inspection Findings
Roots C
Poor Pipe Joints
am
0 pm
Record Number ._.�
Time
/V am
0 pm
Alternative Mailing Address Phone
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
/) Number of stacks Entered S L. at
f
J Y y - f
1 1 2 ..�_a! <.J )
/ 2?.
Length of Ser vice:
Yellow Copy: City of Eagan
r
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
r
1
Pink Copy: SEH