1944 Carnelian Lane - Inspection FormS 33(
4111
City of lio.ao
Residential Sanitary Sewer Service
•
Compliance Inspection
Date / C /
Name , .....PC/Sciki
Disk #
PID Number
House Number /97V
Street Name
Alternative Mailing Addr ess
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
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition:
A/ • E
Time Pm
OwnerlOccyfiant Signature
•■••4 •••
White Copy: Propeity Owner
LE-LE
Z,V/1/62. AA
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Fthone .-
1
, Insp Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks Entered S L at
Notes s i- mc
VAT AJo
Final Cleanout:
•
•
• 0 pm
No Access
O. No one in
0 am
Access to service
lateral needed
0 Inspection
r efused
r .,
/ A /
Pink Copy: SE H
Total
Number
Discilarged
Correctly
Incorrectly
Unknown
Sump pumps
.--
-
-------------
Foundation drains
Roof drains
S 33(
4111
City of lio.ao
Residential Sanitary Sewer Service
•
Compliance Inspection
Date / C /
Name , .....PC/Sciki
Disk #
PID Number
House Number /97V
Street Name
Alternative Mailing Addr ess
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
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition:
A/ • E
Time Pm
OwnerlOccyfiant Signature
•■••4 •••
White Copy: Propeity Owner
LE-LE
Z,V/1/62. AA
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Fthone .-
1
, Insp Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks Entered S L at
Notes s i- mc
VAT AJo
Final Cleanout:
•
•
• 0 pm
No Access
O. No one in
0 am
Access to service
lateral needed
0 Inspection
r efused
r .,
/ A /
Pink Copy: SE H