1647 Sherwood Way - Inspection FormSump pumps
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Foundation drains
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Roof drains
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City of tapaa
Residential Sanitary Sewer Service
Compliance inspection
Date ir:7 " / )1(
Name _. .
PID Number
House Number
4" to b" Transition:
V
Alternative Mailing Address
For in €ormation call 65
Compliance
O No foundation drain connection
No roof drain connection
i Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints_
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
Total
Time
Street Name
Owner /Occupant Signature
7f )
a
• Pm
Dsk #EL — —[1]
ar ff ti �
Phone 7 :a
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Correctly
Incorrectly Unknown
Record =Number o r
Obstruction
Unable to push past
feet
Notes
Time
!
•
Inspector Signature
Final Cleanout:
o am
o Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L. at
.-;7
Yellow Copy: City of Eagan Pink Copy: SEH
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