4346 Nicols Rd - Inspection FormSump pumps
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Foundation drains
Roof drains
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City of Pap
Residential Sanitary Sewer Service
Compliance Inspection
Date "l 1 / /
Name 2 ..f (.4%), rAc7. -r Disk #
PID Number'
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
,,O No sump pump
4" to b" Transition:
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OwnerlOccupaEdI Signature
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection 4f ,f A
Damaged Pipe /
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Transition L� u` ; 1 /4//://t/ J
White Copy: Property Owner
(1 °/ am
Time 1 t � crpm
Total Correctly
LE EH
Street Name
1
Service Lateral inspection Findings Number of stacks
Roots.) 5 -
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
Record Number
Time
•
f inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S..L..at
Length of Service:
Number Discharged
Incorrectly Unknown
Notes
te ...
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH