1555 Sherwood Way - Inspection FormSump pumps
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Foundation drains
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Roof drains
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4" to 6" Transition:
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Residential Sanitary Sewer Service
Compliance Inspection
Date )0/ 1 1
Name .✓ J 4)
PID Number
House Number ) _ ,..
Street Name
Alternative Mailing Address
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cs Owner f ciipantSignature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roottlrain connection
Sump pit not connected o `
sanitary sewer
O Sump pump pro0fIgipe '
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
f j
✓ 4 am
Time f' • "O pm
sk # [1]
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 Entered S,L,at
Length of Service:
Number Discharged
,Total Correctly Incorrectly
Unknown
Record Number
Obstruction
Unable to push past
feet
Notes
Time
lnspe6 or Sign ature
Phone / ` %i:t.' l �>.
Final Cleanout:
O am
•
• - - - _ 0 p
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH