2033 Carnelian Lane - Inspection FormSump pumps
Foundation drains
Roof drains
--
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City or Ea ao
Residential Sanitary Sewer Service
Compliance Inspection
Date_ ! ./ / ) % Time
Name fi 7 ,• r D isk #
PID Number
f
House Number C Street Name
Alter native Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Transition
4" to 6 "Transition:
i: :2- "
f. :gin
White Copy: Property Owner
OwneriOccupant Signature
a
Total
Non - Compliance
0
0
0
O
O
• ter' 2 O am
Xpm
rr�
Number of stacks
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Roots
Poor PipeJoints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Length of Service: !
Number Discharged
Correctly
Incorrectly
Unknown
Record Number
rb
Time
/ �.-�+
Phone
inspector Signature
Obstruction No Access
Unable„,t2 push past 0 No one in
feet.
-r'
Entered S..L.at
Notes
Yc_: 1,/\,/ )Final Cleanout: 7 )
-r- wrfrr
• j 0 am
• 1 pm
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eaga�b i 57/4 fn Pink Copy: SEH