2017 Carnelian Lane - Inspection Form1't55i1
44111
City of Ia o
Residential Sanitary Sewer Service
Compliance Inspection
Date,/ 1 Time
Name
#
PID Number
lam`( L 14 - iL^
am
pm
MINIMMIN
House Number 00,
/2 )7- Street Name
Alternative Mailing Address Phone -4 �
For information tall 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 Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
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
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• O pm
No Access
o No one in
(, 7 Access to service
// ii lateral needed
O Insp`ctiori
refused
Pink Copy: SEH
Total
Notes
6
f i -7
J
�` }}'
_ 97 :'
?-
?_-_
-
-
.
I
e / C'` _ ;
5 "° t~3c�'K
-�#
:' - ./,)
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
'(
:2
Roof drains
1't55i1
44111
City of Ia o
Residential Sanitary Sewer Service
Compliance Inspection
Date,/ 1 Time
Name
#
PID Number
lam`( L 14 - iL^
am
pm
MINIMMIN
House Number 00,
/2 )7- Street Name
Alternative Mailing Address Phone -4 �
For information tall 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 Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
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
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• O pm
No Access
o No one in
(, 7 Access to service
// ii lateral needed
O Insp`ctiori
refused
Pink Copy: SEH
Ellyn talan
Residential Sanitary Sewer Service
Compliance Inspection
1
Date ,-"2 1 1 7
Name R. ) '�' �°�"'� =�� Disk #
PO Number
House Number
Alternative Mailing Address
No roof drain connection
Transition
4" to 6" Transition:
White Copy: Property Owner
cr
�/O /am
Time - • p
OwnerlOccupant Signature
Compliance
No foundation drain connection
f
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Length of Service:
Street Name % /fl l r I ? } =f
Phone i -J / -° rr
For information call 651:470.2788
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
7
Service Lateral Inspection Fi ings Number of stacks Entered S L. at <
W
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Yellow Copy: City of Eagan
Record Number J
0 Time • O pm
Notes
Obstruction
Unable to push past
feet
inspector Signature
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Number.
Correctly
Discharged
Incorrectly
MI
Unknown
Total
Sump pumps
Foundation drains
r
Roof drains
?l
Ellyn talan
Residential Sanitary Sewer Service
Compliance Inspection
1
Date ,-"2 1 1 7
Name R. ) '�' �°�"'� =�� Disk #
PO Number
House Number
Alternative Mailing Address
No roof drain connection
Transition
4" to 6" Transition:
White Copy: Property Owner
cr
�/O /am
Time - • p
OwnerlOccupant Signature
Compliance
No foundation drain connection
f
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Length of Service:
Street Name % /fl l r I ? } =f
Phone i -J / -° rr
For information call 651:470.2788
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
7
Service Lateral Inspection Fi ings Number of stacks Entered S L. at <
W
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Yellow Copy: City of Eagan
Record Number J
0 Time • O pm
Notes
Obstruction
Unable to push past
feet
inspector Signature
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH