1648 Sherwood Way - Inspection FormCity of Ia au
Residential Sanitary Sewer Service
Compliance Inspection
Date I :1 <% �� l �
I( �
Name Disk#
PID Number
Time
House Number Street Name
Alter nativ,MailingAgresj
t '; i / Vii' `t
Owner /Occupant Signature
Compliance
O No foundation drain connection
olloc No roof drain connection
Q ? Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to b" Transition:
White Copy: Property Owner
LL
am
p
Li 1 -[1J
1
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:
Yellow Copy: City of Eagan
Record Number d :l
Phone
Time
j 1
-- inspector Signature
•
O 0 p
0 am
For information call 651:470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S..L at
Roots
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH
Total
Nptes
. --� ( � r' , - .. - -- i 2
1 Y
_
if?,
Nu rrber.Dischar
•
Correctly
Ir correctl
Unknowwft
Sump pumps
/
r"
3. iI ,
in
r ,...•
Foundation drains
Roof drains
City of Ia au
Residential Sanitary Sewer Service
Compliance Inspection
Date I :1 <% �� l �
I( �
Name Disk#
PID Number
Time
House Number Street Name
Alter nativ,MailingAgresj
t '; i / Vii' `t
Owner /Occupant Signature
Compliance
O No foundation drain connection
olloc No roof drain connection
Q ? Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to b" Transition:
White Copy: Property Owner
LL
am
p
Li 1 -[1J
1
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:
Yellow Copy: City of Eagan
Record Number d :l
Phone
Time
j 1
-- inspector Signature
•
O 0 p
0 am
For information call 651:470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S..L at
Roots
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH