4635 Kingsbury Dr - Inspection FormSump pumps
Foundation drains
Roof drains
..._, ...,'
City pi Laftatt
Residential Sanitary Sewer Service
Compliance Inspection
Date .4
• — -
Name ,
Disk #
PID Number
House Number t Street Name /2-
Alter native Mailing Address
Compliance
O No foundation drain connection
t::) No roof drain connection
0/ Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
0 No sump pump
Sag/Pipe Deflection
Damaged Pipe
4" to 6" Transition:
White Copy: Pi operty Owner
OwnerlOccupaa Signature
Total
Time
Non-Compliance
0 Clear water connections to
sanitary sewer
0 Service lateral defects
0 Defective manholes
0 Sump pum`p connected to sariitary
/ sewer /
,
Flexible surnp pump piping
Number. Discharged
Correctly
incorrectly
Unknown
LL
Record Number
Phone
Time
i
)
JD°
Inspecwr Signature )
I l/
For information call 651.470.2788
Obstruction
Unable to push past
feet.
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor PipeJoints
Mineral Deposits
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Transition A/7 / - ......; .6 '' ''f • "=L- . ,'.._---- i
.- --1 --- -- 7 " --1) •-•.--}/-' / I /.- ' 1 --- -jY
, • .--
- 1 _is
r ,
Length of Service: (---/ Final Cleanout:
Notes
-
1 s;•:•••/"'
v
• " I: - - ; ?.f .
I .
•
0 am
• 0 prn
No Access
0 No one in
0 Access to service
lateral needed
0 Inspection
refused
: •
_-•
Yellow Copy: City of Eagan f 4 . ..Pink Copy: SEH
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