3765 Windtree Dr - Inspection FormSump pumps ,.
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Foundation drains
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7%
Roof drains
4 1111. . City of Palau
Residential Sanitary Sewer Service
Compliance Inspection
Name.."' s
- V
PID Number
I-louse Number
Alternative Mailing Address
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
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Transition r
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4" to 6" Transition:
White Copy: Property Owner
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Time 4111,
sto: pm
Street Name
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
' 9 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings Number of stacks 4 Entered S L at
Roots . .
Total
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
-Correctly
• / ;
•
Lerigtil,of Service:
Incorrectly
Number Discharged
Unknown
Yellow Copy: City of Eagan
1
Record Number •
Obstruction
Unable to push past
feet
4/
Inspector Signature
am
Time 1 pm
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Phone .,<•-•, 77 .2 ••=.--"::,
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No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
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•
7 ,•/,
-•••••: Final Cleanout:
Notes
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Pink Copy: SEH