1592 Sherwood Ct - Inspection Form4111111.Eity of Ea o
Residential Sanitary Sewer Service
Compliance Inspection
pp t
Date, /(
Name ¢ , f7 W;. - Disk#
PlD Number
House Number Street Name
Alternative Mailing Address
n
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
4" to 6 " Transition:
White Copy: Property Owner
X 61' am
Time • , pm
OwnerlOccupant1Signature
Service Lateral Inspection Findings
Roots
Poor' Pipe Joints
HLi
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
Number of stacks
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
Entered S.L.at
Notes
Time
Phones" :7
•
e.
Inspector Signature
Final Cleanout:
• p am
• °0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
• .,l
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown_
Sump pumps
1— .
,P
Foundation drains
Roof drains
MEM
4111111.Eity of Ea o
Residential Sanitary Sewer Service
Compliance Inspection
pp t
Date, /(
Name ¢ , f7 W;. - Disk#
PlD Number
House Number Street Name
Alternative Mailing Address
n
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
4" to 6 " Transition:
White Copy: Property Owner
X 61' am
Time • , pm
OwnerlOccupant1Signature
Service Lateral Inspection Findings
Roots
Poor' Pipe Joints
HLi
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
Number of stacks
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
Entered S.L.at
Notes
Time
Phones" :7
•
e.
Inspector Signature
Final Cleanout:
• p am
• °0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
• .,l
Pink Copy: SEH