2136 Carnelian Lane - Inspection FormCity of C'a ao
Residential Sanitary Sewer Service
Compliance Inspection
Date T/
Name
Poor Pipe Joints
s
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
i'+
Transition p J
4" to 6 "Transition:
White Copy: Proper ty Ownet
1
� s Time
PID Number.
House Number �2
! `(4 Street Name
Alternates MailingAddress Phone
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Non - Compliance
O
0
O
O
O
'Q am
pm
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings ember of stacks
Roots )// ) J 2
f 1
Length of Service:
Yellow Gopy: City of Eagan
Record Number
�.1�✓ 0 a
Time -F—� cpm
Obstruction
Unable to push past
feet
Entered S L at
1
77
Inspector Signature
_LEirtal Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
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Number
Discharged
Correctly
lncorr•ectly Unknown
Sump pumps
Foundation drains
Roof drains
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City of C'a ao
Residential Sanitary Sewer Service
Compliance Inspection
Date T/
Name
Poor Pipe Joints
s
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
i'+
Transition p J
4" to 6 "Transition:
White Copy: Proper ty Ownet
1
� s Time
PID Number.
House Number �2
! `(4 Street Name
Alternates MailingAddress Phone
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Non - Compliance
O
0
O
O
O
'Q am
pm
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings ember of stacks
Roots )// ) J 2
f 1
Length of Service:
Yellow Gopy: City of Eagan
Record Number
�.1�✓ 0 a
Time -F—� cpm
Obstruction
Unable to push past
feet
Entered S L at
1
77
Inspector Signature
_LEirtal Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH