1628 Sherwood Way - Inspection FormSump pumps
1C .
1
z
1
Foundation drains
Roof drains
City of to all
Residential Sanitary Sewer Service
Compliance Inspection
1
Date �i 1.._` / , .
Name
°
Compliance
O No foundation drain connection
�
No roof drain connection
,1
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Properry Owner
4 ( °5 • c am
Time f • pm
s
Disk#
PID Number
House Number l Vii' . Street Name
Ow. er/Occupant Signature
Total Correctly
Service Lateral Inspection Findings Number of stacks
Alternative Mailing Address +. ?hone':
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:
Number Discharged
Incorrectly Unknown
Record Number J
•
Time • ° pm
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Notes
f
f
s
Final Cleanout:
0 am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L.at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH