1696 Sherwood Way - Inspection Form<.s
r City Di Eat fl
Residential Sanitary Sewer Service
Compliance Inspection
Date 4' 72 1 !
/ Name � >
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
zi
Time"' e p m
m
Disk #
Owner /Occupant Signature
_1 LE-LE
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
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
Time
•
•
PID Number
House Number ) /' (. 1/7 .7
1 Street Name 'y } /\ �'34 /0 ) / V ) V
Alternative Mailing Address Phone !'
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
o am
O pm
v (7
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
r �/
f (.
Foundation drains
Roof drains
)
<.s
r City Di Eat fl
Residential Sanitary Sewer Service
Compliance Inspection
Date 4' 72 1 !
/ Name � >
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
zi
Time"' e p m
m
Disk #
Owner /Occupant Signature
_1 LE-LE
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
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
Time
•
•
PID Number
House Number ) /' (. 1/7 .7
1 Street Name 'y } /\ �'34 /0 ) / V ) V
Alternative Mailing Address Phone !'
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
o am
O pm
v (7
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH