1651 Sherwood Way - Inspection Form40 111.
lit of F 1 flan
Residential Sanitary Sewer Service
Compliance Inspection
Date // -' -' 1 f 1
Name V , ,J 1 f 1 1Disk #�
PID Number
House Number
Alternative Mailing Address
• iI
)
Owner /Occupant Signature.
For information call 651.470.2788
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
G... • ✓ am
Time f • o pm
Street Name
Non - Compliance
0
O
O
O
O
El-
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe joints_
4" to 6 "Transition:
White Copy: Property Owner
Record Number ' ) -`
Time
•
Phone
2
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Length of Service:
Yellow Copy: City of Eagan
Entered S,L,at
Inspector Signature
Obstruction
Unable to push past
feet,
f
Final Cleanout:
o am
o pm
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH
Total
Notes
6„---„ � cK
.— � , r I l � _ ..
, �r / ".€ 7 k !
Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
....._:_ ,:..J
. ,-, i
_
�-
Foundation drains
Roof drains
40 111.
lit of F 1 flan
Residential Sanitary Sewer Service
Compliance Inspection
Date // -' -' 1 f 1
Name V , ,J 1 f 1 1Disk #�
PID Number
House Number
Alternative Mailing Address
• iI
)
Owner /Occupant Signature.
For information call 651.470.2788
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
G... • ✓ am
Time f • o pm
Street Name
Non - Compliance
0
O
O
O
O
El-
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe joints_
4" to 6 "Transition:
White Copy: Property Owner
Record Number ' ) -`
Time
•
Phone
2
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Length of Service:
Yellow Copy: City of Eagan
Entered S,L,at
Inspector Signature
Obstruction
Unable to push past
feet,
f
Final Cleanout:
o am
o pm
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH