1624 Sherwood Way - Inspection Form4. 1 0 111 ' . . City l Ea pa
Y � u
Residential Sanitary Sewer Service
Compliance Inspection
Date 1.! � 1
Name � i .., )./
PID Number
-` e I
House Number , , Y^:',- - Street Name
✓y ,..A-
Alternative Mailing Address Phone
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Surnp pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings Number of stacks Entered S. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
b '
White Copy: Property Owner
•it..' o
Time - • i3 pm
Disk #
Owner /Occupant Signature
Non - Compliance
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholesv
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Ser vice:
--rT1
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Inspector Signature
• O am
• o pm
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
L (15 i ' t '`' �� • "� f . "
i ,-- , ? �
t
Total
Sump pumps
A /1. 2 �
_.- r ,;'. r
x,, ;11 � ` gg �'4
y
Foundation drains
--
Roof drains
4. 1 0 111 ' . . City l Ea pa
Y � u
Residential Sanitary Sewer Service
Compliance Inspection
Date 1.! � 1
Name � i .., )./
PID Number
-` e I
House Number , , Y^:',- - Street Name
✓y ,..A-
Alternative Mailing Address Phone
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Surnp pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings Number of stacks Entered S. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
b '
White Copy: Property Owner
•it..' o
Time - • i3 pm
Disk #
Owner /Occupant Signature
Non - Compliance
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholesv
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Ser vice:
--rT1
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Inspector Signature
• O am
• o pm
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH