4775 Eriks Blvd - Inspection FormSump pumps
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Foundation drains
Roof drains
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4 ,0 11 ' City of Ca an
Residential Sanitary Sewer Service
Compliance Inspection
Date i( :)!,. )r!
Name
PID Number
House Number Street Name
Alternative Mailing Address Phone (-2__ #'w 41. Z,-2 ( ; ; ;" 2 1
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4” to 6" Transition:
White Copy: Proper Owner
Ownerlbccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
OO Sump pit not connected to
sanitary sewer
a o Sump pump properly piped
y , No sump pump
Service Lateral Inspection Findings
CIO f
Time !c " • /p p
Disk #
sewer
O Flexible sump pump piping
Number of stacks
Length of Service:
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number Discharged
Total Correctly Ineonectl
Unknown 1
Record Number
Notes
Time
Obstruction
Unable to push past
feet
Entered S L.at
0 am
o pm
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Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH