4235 Amber Dr - Inspection FormSump pumps
Foundation drains
f
Roof drains
1ta of Ea o
Resider tiai Sanitary Sewer Service
Compliance Inspection
Date 1
Name ; ) / °, _. r�,"� / Di #
PID Number
House Number \3._µJ Street Name — 74/2-/_ 1 (
' . 2 /
Alternative Mailing Address
For information call 651.470.2788
on� pliance
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 Lateral Ins pertion Findings
Roots /
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 5" Transition:
White Copy: Property Owner
Time • , pm
Owner /Occupant Signature
Non - Compliance
Total Correctly Incorrectly
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
� f
Number of stacks f Entered S.L at
- )4' ?.--
Unknown
Length of Service: e _�
Number ®iischarged
Record Number
Notes
A
Time
Phone Cl _T - C .5' :...
Obstruction
Inspector Signature
Final Cleanout:
♦ � y � am
• �4 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH