4247 Amber Dr - Inspection Formr1
Notes
Number.
Correctly
Discharged
Incorrectly.
Unknown
Total
Sump pumps
"°
"_"--
Foundation drains
Roof drains
City of ta o
Residential Sanitary Sewer Service
Compliance Inspection
Date 0' 1 4Ci 1 / 7
Name P f i F
PID Number
House Number
Transition
Alternative Mailing Address
White Copy: Property Owner
Time
• • f ,efam
• 0 p
Disk #
s - R
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
% No sump pump
Service L eral inspection Findings
Roots r 2/
Poor PipeJoints
Mineral Deposits 97 ,
Sag /Pipe Deflection
Damaged Pipe
/
Street Name . /� k e
For information call 65
4" to 6" Transition: 0' / � Length of Service:
4/1)]
Record Number
c
arty
Time lf! ' 'O prn
Phon 1(
am
/ ' l wector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
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 of stacks ( Entered S L. at �` "i
Yellow Copy: City of Eagan
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
r<
Notes
Number.
Correctly
Discharged
Incorrectly.
Unknown
Total
Sump pumps
"°
"_"--
Foundation drains
Roof drains
City of ta o
Residential Sanitary Sewer Service
Compliance Inspection
Date 0' / 4Ci ! / 7
Name P f i F
PID Number
House Number
Transition
Alternative Mailing Address
White Copy: Property Owner
Time
• • f ,efam
• 0 p
Disk #
s - R
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
% No sump pump
Service L eral inspection Findings
Roots r 2/
Poor PipeJoints
Mineral Deposits 97 ,
Sag /Pipe Deflection
Damaged Pipe
/
Street Name . /� k e
For information call 65
4" to 6" Transition: 0' / � Length of Service:
4/1)]
Record Number
C
Time arty f! ' 'O prn
Phon ,(
am
/ ' l wector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
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 of stacks Entered S L.at �` "i
Yellow Copy: City of Eagan
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH