1652 Sherwood Way - Inspection Formata-
City of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
)7
DateY. /. /
Name
PID Number
° Street Name :.. _- r �/ CsC ! /\ /‹.7 V
House Number 4 ���� � :s
Alternative Mailing Address
•
For information call 651.470.2788
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 Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
•/ 9 am
T ime --_ • ,TD pm
Ownerl0ccupant Signature
Disk #
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 Service:
Yellow Copy: City of Eagan
Record Number i ' r __
Time
Phone (:- .4 , ( )
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
0 am
•
• O Prn
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Unknown
Notes
Total
Correctly
Incorrectly
Sump pumps
_'C ":
/1
� ." --- 1
Y :
3'
!. - -
Foundation drains
I
Roof drains ,
ata-
City of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
)7
DateY. /. /
Name
PID Number
° Street Name :.. _- r �/ CsC ! /\ /‹.7 V
House Number 4 ���� � :s
Alternative Mailing Address
•
For information call 651.470.2788
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 Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
•/ 9 am
T ime --_ • ,TD pm
Ownerl0ccupant Signature
Disk #
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 Service:
Yellow Copy: City of Eagan
Record Number i ' r __
Time
Phone (:- .4 , ( )
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
0 am
•
• O Prn
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH