1503 Sherwood Way - Inspection Form2 .--' -
40* or Residential Sanitary Sewer Service
Compliance Inspection
Date 65' 13 () / I o
Name I_ r
PID Number
House Number
Compliance
O
Q
�Ee 'rte-
s
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Mir
White Copy: Property Owner
Time
Alternate Mailing Address
wner /Occupant Signature
Service Lateral Inspection Findings
,- 4" t 6" Transition: /1,
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
ear i
o am
o pm
Street Name
NI
Record Number �7 /
Time
C\ 2a r +.rant—
Inspector Signature
Phone
o am
O pm
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
o No one in
O Access to service lateral
needed
o Inspection refused
Number of stacks 1 Entered S.L at `7 - .< L C. in
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length•of Service: g5"
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Total
f *t
Correctly Incorrectly Unknown
Notes
Yellow Copy: City of Eagan
Final Cleanout: \
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551