1512 Sherwood Way - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
ity o EaffaR
0
Date - 7 n
Name
PID Number
Transition
House Number
Alternate Mailing Address Phong
,
; X
s's '':O-/Occupant Signature
\ ,
For information call 651.470.2788
c
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
(Sag/Pipe Deflection
Damaged Pipe
f
4" to ", Transition:
White Copy: Property Owner
Time
• ▪ C.DC,)
Non
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
Y1-
Disk #
Number of stacks c Entered S L at c _
` S \
' Length,of Service.
K am
0 pm
Street Name
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
g9
n Time
r 9
;:) sofi
Inspector Signature
P . 1 5? 4
GS
No Access
o No one in
O Access to service lateral
needed
O Inspection refused
o am
o pm
( /0
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
• 651-222-1551
;
Total
_;- : ,
, . , .. ..'.:. '
,
N Ot e s
_
, \
..
•
Number
Discharged
Correctly
Incorrectly , ,:! : ),nknown
Sump Pumps
•
' •"--\-
Foundation Drains
"7
,.;
•s' ; ....
e--- ,.. „, ..
i
\ / F _ L
Roof Drains
..„,
Residential Sanitary Sewer Service
Compliance Inspection
ity o EaffaR
0
Date - 7 n
Name
PID Number
Transition
House Number
Alternate Mailing Address Phong
,
; X
s's '':O-/Occupant Signature
\ ,
For information call 651.470.2788
c
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
(Sag/Pipe Deflection
Damaged Pipe
f
4" to ", Transition:
White Copy: Property Owner
Time
• ▪ C.DC,)
Non
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
Y1-
Disk #
Number of stacks c Entered S L at c _
` S \
' Length,of Service.
K am
0 pm
Street Name
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
g9
n Time
r 9
;:) sofi
Inspector Signature
P . 1 5? 4
GS
No Access
o No one in
O Access to service lateral
needed
O Inspection refused
o am
o pm
( /0
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
• 651-222-1551