1415 Rebecca Lane - Inspection FormSump pumps
`',
r }:7
Foundation drains
fi
7
Roof drains
1 --
1 , 111 '. City of Ca
Residential Sanitary Sewer Service
Compliance Inspection
Date ,% /
Name s.f1
4" to 6 " Transition:
PID Number
House Number � Street Name
White Copy: Property Owner
Tim ee •
Disk #
Owner /Occupant Signature
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
Total
Correctly
am
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 Discharged
Incorrectly
Unknown
Yellow Copy: City of Eagan
Record Number
I 11
Alternative Mailing. ddress Phone
Time
•
•
'inspector Signature
Length of Service: Final Cleanout:
Obstruction
Unable to push past
feet .
•
o am
O pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S . at
Roots
Poor-Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Notes
Pink Copy: SEH