1390 Camelback Dr - Inspection Form4 11 . IIIII. Eity of hp
Residential Sanitary Sewer Service
Compliance Inspection
;') J
Date 3 l —1 1 /
Name 1'?f'�/3 `� Disk#
j
PID Number
House Number ! `"?` 1 Street Name
Alternative Mailing Address .
Compliance
X 'No foundation drain connection
r
Q I No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No surnp pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1
Transition
4" to 6 "Transition:
White Copy: Property Owner
• 7'1 o am
Time m
P
0 er /Occupant Signature
2L
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 "/
Yellow Copy: City of Eagan
Record Number
Phone .
Obstruction
Unable to push past
feet
Entered S.L.at
r7
) Time
i�
• C.?! [/r O, am
• Pm
inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: ! '" i Final Cleanout: .
—`; -
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
,
�{ - .! °J � , ✓! — '7 f %r
Total
S pumps
Sump P
Foundation drains
Roof drains
4 11 . IIIII. Eity of hp
Residential Sanitary Sewer Service
Compliance Inspection
;') J
Date 3 l —1 1 /
Name 1'?f'�/3 `� Disk#
j
PID Number
House Number ! `"?` 1 Street Name
Alternative Mailing Address .
Compliance
X 'No foundation drain connection
r
Q I No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No surnp pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1
Transition
4" to 6 "Transition:
White Copy: Property Owner
• 7'1 o am
Time m
P
0 er /Occupant Signature
2L
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 "/
Yellow Copy: City of Eagan
Record Number
Phone .
Obstruction
Unable to push past
feet
Entered S.L.at
r7
) Time
i�
• C.?! [/r O, am
• Pm
inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: ! '" i Final Cleanout: .
—`; -
Pink Copy: SEH