4637 Cambridge Dr - Inspection Form1
Number Discharged
Notes
Total
Correctly
Incorrectly Unknown
Sump pumps
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Foundation drains
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Roof drains
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4_ 1111 . 16 ' Cif al' a
City p,an
Residential Sanitary Sewer Service
Compliance Inspection
Date 1!I 1 1( . i
Name ! ,/
PID Number
) %' -7 7
House Number : Street Name
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
)/)
VL J , am
Time J. !o pm
Own er /OccrIpant Signature
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Surrrp pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
7r
Record Number
Time
Obstruction
Unable to push past
feet
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J. f :rye
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Alternative Mailing Address Phone r? (�/ l
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Inspector Signature J \ j -- y j ,i /1
For information call 651.470/788
Number of stacks Entered S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Final Cleanout:
• O am
• o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
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