4267 Amber Dr - Inspection FormSump pumps
_ '
Foundation drains
✓t
Roof drains
i
r City of Gael!
Residential Sanitary Sewer Service
Compliance Inspection
Date ?! / 1 12
Name 1 "- i• -
PID Number
House Number (i Street Name �` � !C � G/,`e
Alternative Mailing Address
For information call 651.470.2788
Compliance
iY'No foundation drain connection
p. No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
16
Service Lateral Inspection Findings
l�
Roots � f �"` i S
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
f 04/
Time Pm
Disk #
/ Owner /Occupant Signature
Non - Compliance
0
0
O
0
0
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks 1 Entered S..L.at G cc
ji Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number "4` .5
c
Time //
Obstruction
Unable to push past
feet
Notes
Phone 6 r� - r e
t
Inspector Signature
ei
0 pm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
r efused
Final Cleanout:
/
Pink Copy: SEH