1606 Sherwood Way - Inspection FormSump pumps
Foundation drains
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Roof drains
City of I i
Residential Sanitary Sewer Service
Compliance Inspection
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Date 0 II/ 0 C 1 , Time ; : � b p
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Name ig
Transition %rf ( A'
4" to 6 "Transition:
PID Number
House Number Street Name
Alternative Mailing Address
Owner /Occupant Signature
Compliance
Q No foundation drain connection
O No roof drain connection
9 Sump pit riot connected to
sanitary sewer
0 Sump pump properly piped
1:0
No sump pump
.uf
White Copy: Property Owner
Total
Non - Compliance
Disk #
0
O
0
0
0
1
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
Roots
Length of Service:
Notes ...
Correctly Incorrectly Unknown +;'
Number Discharged
Record Number
ed
O pm
Time
Phone , --S ,c .. 75-C-7
'f ..Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L.at
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Final Cleanout: =
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH