1624 Norwood Dr - Inspection Form1ll o Ea a
Y � n
Residential Sanitary Sewer Service
Compliance Inspection
Date ' .r' � ) j V
Name . r e� F ; ' (1 Disk #
PID Number
House Number Street Name
Alternative Mailing Address
Phone (ra
f� I'
Ownerloccupant Signature
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
No sump pump
Service Lateral Inspection Findings
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
Number Discharged
Total
Correctly
f
Incorrectly Unknown
White Copy: Property Owner
�r • w(2 am
Time. • c pm
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:
Notes
Record Number i
ri Time
Entered S.L at
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
_w O pm
Inspector Signature
,
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH