1499 Sherwood Way - Inspection Form*Is City of Ea pi
Residential Sanitary Sewer Service
Compliance Inspection
Date l I!
Name 2 1 (4,- / ? r ! ! Disk #
PID Number
House Number / A-7' 4 Street Name
Alternative Mailing Address
11 ( F
Poor Pipe joints
Mineral Deposits
Compliance
No foundation drain connection
( No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
SaglPipe Deflection
Damaged Pipe
Transition ! r
4" to 6" Transition:
White Copy: Property Owner
OwnerlOccupant .Signature
am
Time • pm
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:
Yellow Copy: City of Eagan
Record Number
/7
ime •
Phone — t
For information calf 651.470.2788
Obstruction
Unable to push past
feet
Ins ector Signature
f �
am
PM
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S,L.at
Roots
1/
i LFinai Cleanout: �`-
1y
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Y
Foundation drains
r
Roof drains
% )
*Is City of Ea pi
Residential Sanitary Sewer Service
Compliance Inspection
Date l I!
Name 2 1 (4,- / ? r ! ! Disk #
PID Number
House Number / A-7' 4 Street Name
Alternative Mailing Address
11 ( F
Poor Pipe joints
Mineral Deposits
Compliance
No foundation drain connection
( No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
SaglPipe Deflection
Damaged Pipe
Transition ! r
4" to 6" Transition:
White Copy: Property Owner
OwnerlOccupant .Signature
am
Time • pm
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:
Yellow Copy: City of Eagan
Record Number
/7
ime •
Phone — t
For information calf 651.470.2788
Obstruction
Unable to push past
feet
Ins ector Signature
f �
am
PM
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S,L.at
Roots
1/
i LFinai Cleanout: �`-
1y
Pink Copy: SEH