1655 Norwood Dr - Inspection FormSump pumps
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Foundation drains
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Roof drains
4 11. City of ham
Residential Sanitary Sewer Service
Compliance Inspection
Date )
/ /
Name
Alternative Mailing Address
' Sump pit not connected to
i
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Pr operty Owner
Total
Compliance
O No foundation drain connection
O No roof drain connection
Time p
Disk #
PID Number
House Number Ju_..._ Street Name _
OwnerlOccupant Signature
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks Entered S.L at_
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Number Discharged
Correctly Incorrectly Unknown
Record Number
-Fr] El Time
Phone
Obstruction
Unable to push past
feet
Notes
/ /V/,
I
Final Cleanout:
I
o am
o pm
inspector Signature ',k, 4
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
1/
Yellow Copy: City of Eagan Pink Copy: SEH