1690 Sherwood Way - Inspection Form41.
Lly of Ea au
Residential Sanitary Sewer Service
Compliance inspection
1 1 ri
Date f I ` 1 =1 y �
) r
Name ?� Cr , ! 7 ,/ ! Disk #
PID Number
i
House Number ,(i ") . ( 1, Street Name
Alternative Mailing Address
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
Service Lateral inspection Findings
4" to 6 "Transition:
White Copy: Proper ty Owner
W am
Time .fi • /O pm
Owner /Occupant Signature
Non- Compliance
0
0
0
O
0
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Phone
Time
•
•
Inspector Signature
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
Number of stacks Entered S Lat
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH
Total
Notes
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Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
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Foundation drains
Roof drains
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41.
Lly of Ea au
Residential Sanitary Sewer Service
Compliance inspection
1 1 ri
Date f I ` 1 =1 y �
) r
Name ?� Cr , ! 7 ,/ ! Disk #
PID Number
i
House Number ,(i ") . ( 1, Street Name
Alternative Mailing Address
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
Service Lateral inspection Findings
4" to 6 "Transition:
White Copy: Proper ty Owner
W am
Time .fi • /O pm
Owner /Occupant Signature
Non- Compliance
0
0
0
O
0
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Phone
Time
•
•
Inspector Signature
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
Number of stacks Entered S Lat
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH