1643 Sherwood Way - Inspection FormSump pumps
4
Foundation drains
Roof drains
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City E' F�k
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Residential Sanitary Sewer Service
Compliance Inspection
Date t. f
Name
PID Number
1 �� ° ' 1 M
House Number
Compliance
0, No foundation drain connection
Q No roof drain connection
Cf Sump pit not connected to
sanitary sewer
r
Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Ownea
Time
•sk #
Street Name
Owner /Occupant Signature
•i r O1am
• pm
W-
- Th
AIternaive Mailing Address
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
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
d
Phone r;
J
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• O pm
Notes
L _ ;'")
sj
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
I SSS .✓ Aa'� �t.,.
Pink Copy: SEH