4266 Amber Dr - Inspection FormSump pumps
Foundation drains
Roof drains
,...
(...-/
city of liaRp
Residential Sanitary Sewer Service
Compliance inspection
Date "7-/ Z r Time
Name /7 V Disk #
PID Number
House Number
Alternative Mailing Address
For infot call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly,piped
No sump pump
L4-
Street Name
4 Owner/Occupant Signature
• Prn
Non
Record Number
Obstruction
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
•
•
0 am
pn
1 ( 2
)
Phoe47V 1
inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Ser vice Lateral Inspection Findings Number of stacks _ Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition ,
/
4" to 6" Tr ansition:
White Copy: Proper ty Owner
Length of Service:
Yellow Copy: City of Eagan
Notes
Cieanout: 7
Pink Copy: SEH
