845 Wescott Square - Inspection FormSump pumps
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a
a,
Foundation drains
NI
Roof drains
City of Car
Residential Sarnitary Sewer Service
Compliance Inspection
Date eel /0 Time • .5__.E pm
a
Name < ; '`I ` a �3 7 74 Disk#
MD Number
House Number
Alternative Mailing Address
r Owner /Occupant Signature
1
Record Number
Street Name rcc'1'7 ! rr
0 I • .)f O am
Time • O pm
Prone
t
i ;
:inspector Signature
For, information call 651
Compliance
O No foundation drain connection
Sb` No roof drain connection
�:
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
05 No sump pump
Service Lateral Inspection Findings Number of stacks 1 Entered S L. at ' 1 - t4-
Roots
Poor Pipe Joints
Mineral Deposits
'Transition fiA.s / 0 i
4" to 6" Transition:
1A
f
White Copy: Property Owner
Total
Sag/Pipe Deflection Y
f
Non-Compliance
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
Damaged Pipe
3
Cor rectly
Length of Service:
Number, Discharged
Incorrectly Unknown
Obstruction
Notes -- rt .
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout:
f
it (;l
1 )
Yellow Copy: City of Eagan Pink Copy: SEH