4290 Sandstone Dr - Inspection FormSump pumps
Foundation drains
wf
Roof drains
City tiI d Ji
Residential Sanitary Sewer Service
Compliance inspection
i
1
Date ! !,' ; / l i
:House Number
:Alternative Mailing Address
Transition
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
4" to b" Transition:
White Copy: Pr operty Owner
1
a
Name
on>t pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
C ' Sump pump properly piped
No sump pump
Total
0,Z1 am
Time • 1d pm
Disk #
HD Number
t- » - f i Street Name
OwnerlOccupant Signature
For information .call .651
Non- Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pum, connected to sanitary
sewer
O Flexible sump pump piping
i
Service Lateral Inspect oip F F a _ ndings .,...� Number of stacks � .,-= --
tor'rect
y
Length of Service:
Number. Discharged
Incorrectly
Unknown
Record Number
Li2 Time r3
Phone } , ; 6- f
Notes
• _.
•
Inspector Signature
Obstruction
Unable to push past
feet
EnteredS L at
p am
1 0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
ry ;J I x(477)
Final Cleanout: =.
Yellow Copy: City of Eagan Pink Copy: SEH