1369 Grace Dr - Inspection FormSump pumps
4
Foundation drains
Roof drains
.'
4. Lit of to as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name --
PID Number
House Number
Alternative Mailing Address
1 - 7 1 1i` I Time
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O No sump pump
Sump pit not connected to
sanitary sewer
Sump pump properly piped
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 " Transition:
White Copy: Property Owner
•( am
'6 pm
Disk # [-1-
Street Name
OwnerlOccupant Signature
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:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
Time
Phone
Obstruction
Unable to push past
feet
Entered S.L.at
Notes
•
Inspector Signature N
B' .
Final Cleanout:
•
• O pm
a ..
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
0 am
t ' %, / � _. = • ten =' ._r` `'�'. ''%:9
Yellow Copy: City of Eagan Pink Copy: SEH
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