1373 Interlachen Dr - Inspection FormSump pumps
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Foundation drains
Roof drains
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4 City of Caaan
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 / / / I
Name Disk # L j
� III
PID Number
House Number ) J Street Name , 2 f � ' � 1 ;
Alternative Mailing Address Phone I — •� >� �` '�� "� � �
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
�7`� Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings
4" to 6" Transition:
Total
,
Time _ 1/1* • o pm
Non - Compliance
O
O
O
O
O
am
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Number Discharged
Correctly Incorrectly
Unknown
White Copy: Proper ty Owner Yellow Copy: City of Eagan
Record Number 7 T
Time
Entered S.L.at
N otes
•
inspector Signature
obstruction
Unable to push past
feet.
Final Cleanout:
o am
O pin
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH