4284 Sandstone Dr - Inspection FormSump pumps
Foundation drains
2)
Roof drains
City of tig,ao
Residential Sanitary Sewer Service
Compliance Inspection
7 am
6 1 /(i Time pm
Name 1 / i/ ' � Disk #
PID Number
Date
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
No sump pump
Service Later I lnspeetio
Roots
Poor Pipe Joints
4" to 6" Transition:
White Copy: Property Owner
Street Name
Total Correctly
Ownerl0ccupant Signature
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
3 f
'Transition � 1 (9
Length of Service:
Incorrectly Unknown
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 Discharged
Record Number
Phone
For information call 651.470.2788
Obstruction
Unable to push past
feet
_, Number of stacks !_ Entered S L at
� VV
Notes
e"7
7 O am
Time • pm
}
l i
2
Inspector Signature
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
2