1421 Rebecca Lane - Inspection FormSump pumps
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Foundation drains
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Roof drains
City at hap
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 / 1 / 1
•; V am
Time / • frik pm
Name. i r J • p 7 � - Disk #
ND Number
House Number
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Street Name
Owner /Occupdnt Signature
For information call 651.470.2788
Compliance
f i
A Sump pit not connected t o
sanitary sewer - i� / �" }` 4
o Sump pump properf e )
O No sump pump
No foundation drain connection
No roof drain connection
Service Lateral Inspection Findings
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
Length of Service:
Yellow Copy: City of Eagan
Record Number.
Phone
oam
i ...2
Time • • ` pm
■;--5 14-,E
Obstruction
Unable to push past
feet
Inspector Signature
Entered S..L..at ._ <-
j din Cleanou
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 '77"?
Total
Number Discharged
Correctly
Incorrectly Unknown
Notes
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Pink Copy: SEH