2065 Carnelian Lane - Inspection FormSump pumps
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Foundation drains
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Roof drains
4 Ib
City of Cava
Residential Sanitary Sewer Service
Compliance . inspection
Date l) / I
Name , 1 } 1? Disc #
RD Number
House Number i a Street Name
Alternative Mailing Address
Owneridccupant Sigrdt. ure
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
0 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral In
Roots /
Poor Pipef oints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
pection Findings
2
White Copy: Property Owner
Time J
1 r �
'/
5
Phone
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 1
r
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
t�-
Entered S.L. at
Notes
I
r
r oam
Time l • • - pm
Inspector Sinature
Obstruction
Unable to push past
feet
/)
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH