1520 Wellington Way - Inspection FormSump pumps
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Foundation drains
Roof drains
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City of Favan
Residential Sanitary Sewer Service
Compliance Inspection
Date if ,) / ('; / , J)
Name Disk #
PID Number
House Number i ( �� Street Name
Alternative Mailing Address Phone ,
O No roof drain connection
Sump pit not connected to
sanitary sewer
AftSump pump properly piped
O No sump pump
4" to 6 "Transition: •
White Copy: Property Owner
� • am
Time ▪ • ' pm
Owner /Occupant Signature
Compliance
O No foundation drain connection
Total
1- -FT
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
Length of Service: ,
Number Discharged
Correctly
Incorrectly Unknown
Record Number
Time
Obstruction
Unable to push past
feet
Notes
Jt ?�+
• o am
• o pm
Inspector Signature Nil /
For information calf 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 S L at
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
,e ms
Final Cleanout:
•
Yellow Copy: City of Eagan Pink Copy: SEH