915 Wild Rose Ct - Inspection FormSump
Sup pumps
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Foundation drains
Roof drains _
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City of Fla ap
Residential Sanitary Sewer Service
Compliance Inspection
Dates 1
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Name J `° " _ - .._ r.�.:�_ " Disk #
PID Number
House Number P Street Name
Alternative Mailing Address
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irrf A i f , . ' � 1 J ' vi
ow,erIOqupant Signatdf
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Compliance
O No foundation drain connection
47 No roof drain connection
Sump pit not connected to
sanitary sewer
, • Sump pump properly piped
O No sump pump
PoorPipeJoints < -' . % .. f ° ° 4 . _ !. 7
Transition
4" to 6 " Transition:
White Copy: Property Owner
1 r T ys.
Total
Time
Service Lateral Inspection Findings
Roots
r�r
Correctly
pm
For information call 651.470.2788
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Length of Service:
Number Discharged
Incorrectly
Unknown
Yellow Copy: City of Eagan
Record Number r
Notes
Time
Phone r:' , P. I -6- <:
Inspector Signature
Obstruction
Unable to push past
feet
Entered S at
am
• o pm
No Access
O ' in
O Access to service
lateral needed
O Inspection
refused
/
4,1'4 ..Final Cleanout:
:2
Pink Copy: SEH