4622 Cambridge Dr - Inspection FormSump pumps
i
1
/1
Foundation drains
Roof drains
411111
City of boa
Residential Sanitary Sewer Service
Compliance Inspection
Date )1 , 1
e " --Ay
Name f ./
PID Number
House Number
Alternative Mailing Address
For information call 651.470.2188
Compliance
O No foundation drain connection
No roof drain connection
® Sump pit not connected to
sanitary sewer
d' Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
V f Ownerloccupant Signature
•
am
pm
W
Street Name _ _. t
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
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number `" )
Entered S L. at
= rv.
Time
•
Phone
inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Final Cleanout:
Notes
J ..
O am
O pm
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH