1639 Norwood Dr - Inspection FormSump pumps
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i
- ]
Foundation drains
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Roof drains
,
4111111 City M WI
Residential Sanitary Sewer Service
Compliance Inspection
f 7
Date: !/ )1 / /
Name r
PID Number
7
House Number I I% ?" J Street Name
Alter native Mailing Address
7
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
9R No sump pump
4" to 6 "Transition:
White Copy: Property Owner
e am
Time . • � pm
Disk #
7
Ownerl0ccupant Signature
0
O
O
O
0
Non - Compliance
Clean water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
) \
Phone
Time
Obstruction
Unable to push past
feet.
Notes
•
•
Inspector Signature
Final Cleanout:
o am
o pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral inspection Findings Number of stacks Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH