4737 Eriks Blvd - Inspection FormSump pumps
Foundation drains
Roof drains
/- -,-
----
City al' Eaan
Residential Sanitary Sewer Service
Compliance Inspection
(70
Date )p' _ /
Name "..2 Disk #
ND Number
House Number Street Name
Alternative Mailing Address
(.2
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
o Sump pit not connected to
sanitary sewer
O Sump pump properly piped
\ 9 / No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Proper ty Owner
Time •
Owner/Occupant Signature
am
Pm
1 0.1,43,
ef..,'" .
Phone
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
Length of Service:
Number Discharged
Total Correctly
Incorrectly
Unknown
Yellow Copy: City of Eagan
Record Number
Notes
Time
Entered S.L.at
r ,
) 147: J
-
Obstruction
Unable to push past
feet
Final Cleanout:
- •
• o pm
inspector Signature .;;\. (
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH