1632 Sherwood Way - Inspection Form4 11 ' City f Ca an
y �
Residential Sanitary Sewer Service
Compliance Inspection
i (2 • 1
Date ? i 1 i
°? ai )„,0
Name ' Q —,• r � e
PID Number
House Number r, :.= . " ±A Street Name
Alternative Mailing Address
For information calf 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Id 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
4" to 6" Transition:
White Copy: Property Owner
Time -
Disk # [11
Owner /Occupant Signature
;(: am
pm
Phone r
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
Oam
•
• O pm
Inspector Signature i
I'' lP/
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
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Y99 3
,
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Foundation drains
Roof drains
. ,
4 11 ' City f Ca an
y �
Residential Sanitary Sewer Service
Compliance Inspection
i (2 • 1
Date ? i 1 i
°? ai )„,0
Name ' Q —,• r � e
PID Number
House Number r, :.= . " ±A Street Name
Alternative Mailing Address
For information calf 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Id 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
4" to 6" Transition:
White Copy: Property Owner
Time -
Disk # [11
Owner /Occupant Signature
;(: am
pm
Phone r
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
Oam
•
• O pm
Inspector Signature i
I'' lP/
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH