1515 Wellington Way - Inspection FormRestdential Sanitary Sewer Berke
Compliance Inspection
Date 7 / 1 } 0
Name
P1D Number
House Number
Alternate Mailing Address
X
Transition
Compliance
No foundation drain connection
No roof drain connection
6 Sump pit not connected to
sanitary sewer
0 Sump Pump properly piped
No sump pump
Sag /Pipe Deflection
Damaged Pipe
4" to 6" Transition:
White Copy: Property Owner
Time
7
Owner /Occupant Signature
Disk #
1 ` Name
For Information call 651.470.2788
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
Roots
Poor Pipe Joints
Mineral Deposits p
o am
o pm
Length of Service:
Yellow Copy: City of Eagan
Record Num c
ber
Obstruction
Oic
Time
Phone
Unable to push past
feet
Inspector Signature
Service Lateral Inspection Findings Number of stacks Entered S L at
Final Cleanout:
o am
o pm
No Access
O No one in
o Access to service lateral
needed
O Inspection refused
c) A
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
r 3otal
Correctly Incorrectly Unknown
Notes
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551