1492 Sherwood Way - Inspection Formas
Residential Sanitary Sewer Berke
Compliance Inspection
Date - 7 / C / ) Q
Name ''e r e5a
PlD Number
House Number
IL-1 ic9
CJ . %
Alternate Mailing Address Phone - 33 71 7
•
For Information call 651.470.2788
Owner /Occupant Signature
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
:: () Sump Pump properly piped
No sump pump
Time
Service Lateral Inspection Findings
Roots
Poor Pipe Joints ,w .
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
3_s -c-
4" to 6" Transition: 3 3
White Copy: Property Owner
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
Number of stacks
am
pm
Street Name
t
Yellow Copy: City of Eagan
Record Number 9 1 = 3 1
Obstruction
S LL
Time
Unable to push past
feet
Length of Service: j
Inspector Signature
Entered S L at
G-
O am
o pm
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
J-1 4 3_s. =7 4 P .. .c
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Number
Correctly
Discharged
incorrectly Unknown
tJ
Notes V`r °' �'�`�'
" rev- 149-r_25-0 g S ..- 7
Total
Sump Pumps
C?' ®
Foundation Drains
®--
(f�
Roof Drains
as
Residential Sanitary Sewer Berke
Compliance Inspection
Date - 7 / C / ) Q
Name ''e r e5a
PlD Number
House Number
IL-1 ic9
CJ . %
Alternate Mailing Address Phone - 33 71 7
•
For Information call 651.470.2788
Owner /Occupant Signature
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
:: () Sump Pump properly piped
No sump pump
Time
Service Lateral Inspection Findings
Roots
Poor Pipe Joints ,w .
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
3_s -c-
4" to 6" Transition: 3 3
White Copy: Property Owner
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
Number of stacks
am
pm
Street Name
t
Yellow Copy: City of Eagan
Record Number 9 1 = 3 1
Obstruction
S LL
Time
Unable to push past
feet
Length of Service: j
Inspector Signature
Entered S L at
G-
O am
o pm
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
J-1 4 3_s. =7 4 P .. .c
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551