2133 Carnelian Lane - Inspection FormCity of kap
Residential Sanitary Sewer Service
Compliance Inspection
Date 07 0:1" / �rJ
Name / % i >/' / 2 4 Disk #
PID Nunibe)
4" to 6" Transition:
White Copy: Property Owner
Time i- • .CC) o p
Owner ccupant Signature
Compliance
O No foundation drain connection
!.O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
0 s
0
-L
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
Yellow Copy: City of Eagan
Record Number
Alternative Mailing Address
House Number 2 / Street Name r i ✓ /, Qrt> C
Phone
Length of Service: / tr3
Time
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks / Entered S L at
Roots /0 i; /0/ , $ (.,1
Inspector Signature
For information call 651.470.2788
No Access
0 No one in
O Access to service
lateral needed
O Inspection
refused
Cam' ICJ.
Poor Pipef oints
Mineral Deposits. ,-
/ 7 Sag/Pipe Deflection - rw �,se , ... i. / /r) /7` /-1 -r 3, ' _ ` j�� (., ,,
7 2r1 /.�.r./
Damaged Pipe / -'
Transition // / 4 d , / /,/ ` 'ct /d /1
/ /r te
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
N otes ... t i i �,, � (7 r ., ... r
. f C' IJ!6 ( -.5' "~ - ta - C0
— tl /'C ,/Ja If `��
It/C4/16:
-.
Total
Sump pumps
Foundation drains
,;,
Roof drains
•
/
City of kap
Residential Sanitary Sewer Service
Compliance Inspection
Date 07 0:1" / �rJ
Name / % i >/' / 2 4 Disk #
PID Nunibe)
4" to 6" Transition:
White Copy: Property Owner
Time i- • .CC) o p
Owner ccupant Signature
Compliance
O No foundation drain connection
!.O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
0 s
0
-L
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
Yellow Copy: City of Eagan
Record Number
Alternative Mailing Address
House Number 2 / Street Name r i ✓ /, Qrt> C
Phone
Length of Service: / tr3
Time
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks / Entered S L at
Roots /0 i; /0/ , $ (.,1
Inspector Signature
For information call 651.470.2788
No Access
0 No one in
O Access to service
lateral needed
O Inspection
refused
Cam' ICJ.
Poor Pipef oints
Mineral Deposits. ,-
/ 7 Sag/Pipe Deflection - rw �,se , ... i. / /r) /7` /-1 -r 3, ' _ ` j�� (., ,,
7 2r1 /.�.r./
Damaged Pipe / -'
Transition // / 4 d , / /,/ ` 'ct /d /1
/ /r te
Final Cleanout:
Pink Copy: SEH