1568 Sherwood Way - Inspection Form4 1111 ' City of boo
Residential Sanitary Sewer Service
Compliance Inspection
Date
1
,••
j iE
Name )/7Disk#
PID Number
House Number , Street Name
Alternative MailingAddregi
./
Owner/Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
arn
Time .41-,"_411 4 PM
White Copy: Property Ownel
4" to 6" Transition:
Service Lateral Inspection Findings
L
)
/,,-
'••-•• •
1/1
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:
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan
Record Number
Time
7 1
Phone — --)."°")
- -
- - -
Obstruction
Unable to push past
feet.
,.
Inspector Signature
Entered S L at
Final Cleanout:
0 am
•
• 0 Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
i
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-.....,,/ 4-...-..„„...--, ,-/-
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
I i
e/ ...• --.}
—:„..' . \-.' ..---.
. - ,.:••-,••-., e
-- 1 1 i ,."
,
A
(
.
/---
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/
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—, 4
..---,...,
Foundation drains
,
:
Roof drains
..,.,_,..,•••
- ------::::.?
4 1111 ' City of boo
Residential Sanitary Sewer Service
Compliance Inspection
Date
1
,••
j iE
Name )/7Disk#
PID Number
House Number , Street Name
Alternative MailingAddregi
./
Owner/Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
arn
Time .41-,"_411 4 PM
White Copy: Property Ownel
4" to 6" Transition:
Service Lateral Inspection Findings
L
)
/,,-
'••-•• •
1/1
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:
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan
Record Number
Time
7 1
Phone — --)."°")
- -
- - -
Obstruction
Unable to push past
feet.
,.
Inspector Signature
Entered S L at
Final Cleanout:
0 am
•
• 0 Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH