4325 Amber Dr - Inspection FormSump pumps
Foundation drains
>` t
Roof drains
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City of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date KT7 1 I iL / Time pm
Name S �i G _ •/" sk hr
PID Number
House Number.
Alternative Mailing Address
For information call 65 1.470:2788
Compliance
O. No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
_ Street Name
OwnerlOccupant Signature
Service L. teral Insp ctj n ndings
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition f / `'
4" to 6" Transition:
White Copy: Property Owner
Total
I)
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: ::. ,
Number Discharged
Correctly
Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
,Time . _� •
Phone
Obstruction
Unable to push past
feet
Entered S.L at
!
1
Inspector Signature
9 am
l i pm
O Inspection
refused
No Access
O No one in
O Access to service
lateral needed
i I
Final Cleanout: / —
Note
1)
� p t 7 --
Pink Copy: SEH