3635 Great Oaks Cir - Inspection Form/ �. _y.� ; t �,
a
Number`. Discharged
Unknown
Notes
Total
Correctly
Incorrectly
Sump pumps
e,
Foundation drains
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__-- - -°'•"
° °�
µ,`
Roof drains
, .__.._._.
City of bpi
Residential Sanitary Sewer Service
Compliance Inspection
Date a / l ��
Name / 4 =1 721ac / (
HD Number
House Number
Alternative Mailing lyddress
1,i
OwnerlOccupant Signature
Compliance
'o foundation drain connection
o roof drain connection
Sump pit riot connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
4" to 6 "Transition:
White Copy: Property Owner
�1: &
Time O am
� • J �^pm
7
Disk #
Number of stacks t .
Cit H
Street Name J�J
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: .. V
Yellow Copy: City of Eagan
Record Number e�=1
D
r °/am
Time I ` f • •-- - 0- -
Ppbne �5 . 76e_ lC�l� c J
7 ,J,, ;inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
Entered S.L.at 'i # /( /
Final Cleanout:
O Access to service .
lateral needed
O Inspection
refused
Service Lateral Inspection Findings
Roots
Poor PipeJoints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH