1516 Sherwood Way - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
City or ap
Date 7 1'S Ij 0
Name r �� (� r
PlD Number
House Number / 1(,.
Alternate Mailing Address
Compliance
No foundation drain connection
No t'
1
o roof rain connection
Sump pit not connected to
sanitary sewer
t,e$ Sump Pump properly piped
� '0 No sump pump
Time
Owner /Occuparrit Signature
Service Lateral inspection Findings
Roots
4" to 6" Transition: / 7 4 ,,
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
o am
o pm
Poor Pipe Joints i 3 � i f (3 L11 � i II 1 i , 3 9
I -
Length of Service: /
Yellow Copy: City of Eagan
Record Number o2 1 ,23 ( 5
Obstruction
Street Name 5. . '7
CAS" 7 -as-7J - - 79 3
Time
Phone
Unable to push past
feet
Inspector Signature
For Information call 651.470.2788
Number of stacks c Entered S L at '.
No Access
a No one in
o Access to service lateral
needed
o Inspection refused
o am
o pm
C-I 0
Mineral Deposits
Sag /Pipe Deflection 5
Damaged Pipe
Transition
Final Cleanout:
Copy: Benjamin Franklin Plumbing
651 - 222 -1551
Total
Notes
iil S --- 1.„_: c- , C L.?, 0..a r
C ';.vusy s l _ . l am, .
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Foundation Drains
Roof Drains
i p
Residential Sanitary Sewer Service
Compliance Inspection
City or ap
Date 7 1'S Ij 0
Name r �� (� r
PlD Number
House Number / 1(,.
Alternate Mailing Address
Compliance
No foundation drain connection
No t'
1
o roof rain connection
Sump pit not connected to
sanitary sewer
t,e$ Sump Pump properly piped
� '0 No sump pump
Time
Owner /Occuparrit Signature
Service Lateral inspection Findings
Roots
4" to 6" Transition: / 7 4 ,,
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
o am
o pm
Poor Pipe Joints i 3 � i f (3 L11 � i II 1 i , 3 9
I -
Length of Service: /
Yellow Copy: City of Eagan
Record Number o2 1 ,23 ( 5
Obstruction
Street Name 5. . '7
CAS" 7 -as-7J - - 79 3
Time
Phone
Unable to push past
feet
Inspector Signature
For Information call 651.470.2788
Number of stacks c Entered S L at '.
No Access
a No one in
o Access to service lateral
needed
o Inspection refused
o am
o pm
C-I 0
Mineral Deposits
Sag /Pipe Deflection 5
Damaged Pipe
Transition
Final Cleanout:
Copy: Benjamin Franklin Plumbing
651 - 222 -1551