837 Ivy Lane - Inspection FormSump pumps
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Foundation drains
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Roof drains
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4111
City of Rapo
Residential Sanitary Sewer Service
Compliance Inspection
Datec; / A
Alternative Mailing Addr ess
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary
• Sump pump properly piped
O No sump pump
Roots 1 (11 /*)./
Transition
4" to 6"Transition:
White Copy: Pr operty Owner
Total
Time
Name /1 / Disk #
PID Number
House Number - 460.6 / Street Name
Service Lateral Inspect on Fir ings
) am
• pm
Correctly
1 605f-1\ 1, --ca-.—\
OwnerlOccupant Signature
For information call 651.470.2788
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
N drab er of stacks Entered S L at
LI,— A (
Poor Pipejoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Length of Service:
Number Discharged
Incorrectly Unknown
1
Record Number
Time
)
-
Phone
Obstruction
Unable to push past
feet
;
) • '--
• .0
Inspector Signature
O Inspection
refused
No Access
O No one in
O Access to service
lateral needed
Final Cleanout:
Yellow Copy: City of Eagan. Pink Copy: SEH