2013 Carnelian Lane - Inspection Form41111
Cii ill Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date / � 1 ) ; _,
•
Name Disk #
PID Number
House Number h Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Transition
Sump pumps
Roof drains
n
i fI J f
Ownerl0ccupant Signature
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots / }} . ;
Poor Pipe Joints f '_ r, '
Foundation drains
1
4" to 6" Transition:
White Copy: Property Owner
r _ 'L/ ( am
Time ?; f • o pm
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
Yellow Copy: City of Eagan
Record Number
Time 1r •
Phone r 1 ° .2 ,9" /7�-- f�- `l �ji� s
Inspector Signature
Obstruction
Unable to push past
feet
Entered S.L. at
Notes
}
final Cleanout:
am
O pm
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SFH