4643 Cambridge Dr - Inspection FormSump pumps_,
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Foundation drains
Roof drains
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1
Residential Sanitary Sewer Service
Citj o 1 ail Compliance Inspection
2 /4
Date fr /1
3 ^�
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
4” to 6" Transition:
White Copy: Propel ty Owner
Total
Time
PID Number
House Number • (, ...)Street Name
Service Lateral Inspection Findings
•
Disk #
Owner /Occupant Signature
o am
pm Record Number
EL - - [II
For information . call 65 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
Number Discharged
Cor rectly
Incorrectly
Yellow Copy: City of Eagan
Entered S.L.at
Inspector Signature
Obstruction
Unable to push past
feet
Length of Service: Final Cleanout:
• Q am
Time • O pm
4 1
i r ,. -�
Phone
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
1 f
Unknown (I•- . i //
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r /1
Pink Copy: SEH