1684 Sherwood Way - Inspection FormCity of Ea ai
Residential Sanitary Sewer Service
Compliance Inspection
Date i 1,..,_ (�!I
Name - ,4 /" ::11 I Disk #
PID Number
ra
House Number f. - -> > Street Name
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit noc connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Non - Compliance
O
O
O
O
Service Lateral Inspection Findings
O
1
Phone
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
ID am
•
Time • O pm
Obstruction
Unable to push past
feet
Inspector Signature 7\ }
Final Cleanout:
No Access
O No one in
O Inspection
refused
Number of stacks Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
O Access to service
lateral needed
Pink Copy: SEH
Total
Notes
i
_ �- ,
` > >y7'
Ci. '"
i
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f P G =
r1.4 C/ , ,.
'
: �
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
f .
U✓
''
~ '
Foundation drains
Roof drains
City of Ea ai
Residential Sanitary Sewer Service
Compliance Inspection
Date i 1,..,_ (�!I
Name - ,4 /" ::11 I Disk #
PID Number
ra
House Number f. - -> > Street Name
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit noc connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Non - Compliance
O
O
O
O
Service Lateral Inspection Findings
O
1
Phone
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
ID am
•
Time • O pm
Obstruction
Unable to push past
feet
Inspector Signature 7\ }
Final Cleanout:
No Access
O No one in
O Inspection
refused
Number of stacks Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
O Access to service
lateral needed
Pink Copy: SEH