4357 Copper Pt - Inspection FormSump pumps
Foundation drains
- °
Roof drains
` City of Ea aii
Residential Sanitary Sewer Service
Compliance Inspection
Date 07i Ott
Name
HD Number
House Number
2 7(701
Alternative Mailing Address
Compliance
O No foundation drain connection
e a
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
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White Copy: Property Owner
Total
Time f
Disk #
• e. ?:,f • Street Name
Owner /Occupant Signature
• o am
• ; O - pm
Ltd
�t7 -- 4'
v
For information call 651
Non - Compliance
Clear water connections to
sanitary sewer ros { ,,.
O Service lateral defects Pr
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered 5 L at
Roots
Poor Pipe Joints
Length of Service:
Number Discharged
Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
0
E
%. • // r - o,,am
Time 1 • / .1 6'
PhRne _ ' } _
-/
1 /t ' 2' /
`•-/ ✓ 1 Signature
Obstruction No Access
Unable to push past 0 No one in
feet
37— 06-ify
Notes
74c1 c7
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
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Pink Copy: SEH