1374 Camelback Dr - Inspection FormCity at f a ti
Residential Sanitary Sewer Service
Compliance Inspection
Date O / /
Name
, /J.41? -azisk #
PID Number
House Number Street Name
:
_. r
OwnerlOccupant Signature
Compliance
No foundation drain connection
•\No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
•
Time • o pm
O
0
O
0
0
0
3
Non - Compliance
z
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number -
• d
• o pm
Time
Alternative Mailing Address Phone I lJ
Inspector Signature
For information call 65 l .410.2788
Obstruction
Unable to push past
feet.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S. L at Fit (
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition f, / iJ
f7- Final Cleanout: - r'
,i9& ' o / _
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
MI
Foundation drains
le
Roof drains
City at f a ti
Residential Sanitary Sewer Service
Compliance Inspection
Date O / /
Name
, /J.41? -azisk #
PID Number
House Number Street Name
:
_. r
OwnerlOccupant Signature
Compliance
No foundation drain connection
•\No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
•
Time • o pm
O
0
O
0
0
0
3
Non - Compliance
z
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number -
• d
• o pm
Time
Alternative Mailing Address Phone I lJ
Inspector Signature
For information call 65 l .410.2788
Obstruction
Unable to push past
feet.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S. L at Fit (
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition f, / iJ
f7- Final Cleanout: - r'
,i9& ' o / _
Pink Copy: SEH