4762 Cypress Pt - Inspection FormSump pumps
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Foundation drains
Roof drains
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Residential Sanitary Sewer Service
Compliance Inspection
Date J / K - / /7
Name,
PID Number
House Number
Alternative Mailing Address
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For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
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Ct Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings . Number of stacks Entered S. L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
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White Copy: Property Owner
Time •
4
f it) Disk #
Owner /Occupant Signature
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Pm
. F2
-.4 Street Name =w
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:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number —
Obstruction
Unable to push past
feet
Notes
Time
•
•
o am
o pm
Phone �2
Inspector Signature i �
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH