1561 Sherwood Way - Inspection Form4, 1111. City f Ea pa
y � s
Residential Sanitary Sewer Service
Compliance Inspection
! t r Time
Date � # 1 � A �, �•
Name
PID Number
4" to 6 "Transition:
House Number ) _ /., i f.e;�;)'. Street Name
t
Alternative Mailing Address J ,
White Copy: Property Owner
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
p No sump pump ? a }
rz� Disk#
am
pm
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
Length of Service:
Yellow Copy: City of Eagan
Record Number —
Time
Phone rr'
Obstruction
Unable to push past
feet
Final Cleanout:
O am
• o pm
inspector Signature d `
f ; =� ,r if' t�
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 S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
3
1 'i
i
-a,
i
i .
-
.' r l
:- i
s !°
f`
l .:' '
y
i
�..
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
) \ J !
1
? 4-
-
f
= 1 �,
� 1
,�,a it1
j �'`'
Foundation drains
.
'1...
. ; 1f'
,! :
- -�
Roof drains
C
`,
�7
, .:
m )' , .
/
l
.� !
1
_- /ri 1-
4, 1111. City f Ea pa
y � s
Residential Sanitary Sewer Service
Compliance Inspection
! t r Time
Date � # 1 � A �, �•
Name
PID Number
4" to 6 "Transition:
House Number ) _ /., i f.e;�;)'. Street Name
t
Alternative Mailing Address J ,
White Copy: Property Owner
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
p No sump pump ? a }
rz� Disk#
am
pm
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
Length of Service:
Yellow Copy: City of Eagan
Record Number —
Time
Phone rr'
Obstruction
Unable to push past
feet
Final Cleanout:
O am
• o pm
inspector Signature d `
f ; =� ,r if' t�
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 S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH