4647 Kingsbury Dr - Inspection FormSump pumps
,_ {
! . I C J
1 :
/
,
9 ...
Foundation drains
Roof drains
City of Ea au
Residential Sanitary Sewer Service
Compliance Inspection
Date )' / ,' v
Nam V
r
e .'�,s ,. .r�;
Alternati e MailingAddre$s
OAAAA
Compliance
O No foundation drain connection
O No roof drain connection
t Sump pit not connected to
sanitary sewer.
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
Total
'i• (or am
Time : • p pm
Disk #
PID Number
House Number = 3 fr . Street Name
O wnerlOccupant Signature
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number Discharged
Correctly
-L
Incorrectly
)/2 )
Length of Service:
Unknown
White Copy: Propel ty Owner
Record Number
Phone
Obstruction
Unable to push past
feet
Entered S.L at
Notes
0 am
•
Time • o pm
'' ,
lnspect6r Signature I
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH