4795 Eriks Blvd - Inspection FormSump pumps
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Foundation drains
Roof drains
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City el Ea n
Residential Sanitary Sewer Service
Compliance Inspection
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Date T • pm
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Name 1°2, n 1 ,)071,4 ) Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
ThStreet Name
Owner /Occupant Signature''
MIMEO
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
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number Discharged
Total I Correctly Incorrectly Unknown
Record Number
Obstruction
Unable to push past
feet .
o am
Time • o prn
•
Length of Service: Final Cleanout:
Phone - t`; . _lam
Inspector"Signoture A4
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
Yellow Copy: City of Eagan Pink Copy: SEH