1529 Sherwood Way - Inspection Formor E
Residentta 1 Sanitary Sewer Service
Compliance inspection
Date ( _ 1 <o I 1 (-)
Name — c) .,:„
PID Number
House Number
Alternate Mailing Address
/ / ] /( 2/� ,
For Information call 651.470.2788
Compliance
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
Transition
1
wrr r /Occupant Signature
White Copy: Property Owner
4" to 6" Transition:
Time
i t am
9 <:C7 0 pm
Disk #
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
1
Street Name
Number of stacks
Yellow Copy: City of Eagan
Length of Service:
Record Number
Obstruction
Time
Unable to push past
feet
0 1 03 5
Phone
Inspector Signature
Entered S. L. at
o am
o pm
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
9 3 3 -I. Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump Pumps
d
Foundation Drains
I--
®---
Roof Drains
or E
Residentta 1 Sanitary Sewer Service
Compliance inspection
Date ( _ 1 <o I 1 (-)
Name — c) .,:„
PID Number
House Number
Alternate Mailing Address
/ / ] /( 2/� ,
For Information call 651.470.2788
Compliance
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
Transition
1
wrr r /Occupant Signature
White Copy: Property Owner
4" to 6" Transition:
Time
i t am
9 <:C7 0 pm
Disk #
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
1
Street Name
Number of stacks
Yellow Copy: City of Eagan
Length of Service:
Record Number
Obstruction
Time
Unable to push past
feet
0 1 03 5
Phone
Inspector Signature
Entered S. L. at
o am
o pm
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
9 3 3 -I. Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551