2105 Copper Lane - Inspection FormSump pumps
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Foundation drains
Roof drains
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" City of }aa
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 J 1 )f ..
K • I
Name ,..."
Roots
P[D Number
House Number
Alternative Mailing Address
Owner /Occupant Signature
For information call 65
Compliance
V No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
�7 No sump pump
/!
Service Lateral Inspection Findings Number of stacks 4
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe E J
Transition
4" to 6" Transition:
CV
White Copy: Property Owner
Street Name _ i=?
Time ) �1 am
• pm
isk ##
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
Length of Service:
Number Discharged
Total Correctly incorrectly Unknown
Yellow Copy: City of Eagan
Record Number'
Inspector S
} • J � a p am
Time ! • pm
•
Phone
Obstruction
Unable to push past
feet
Entered S,Lat
r
Notes
Z 'f
,L'1 t final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/2
Pink Copy: SEH