2139 Carnelian Lane - Inspection FormSump pumps
Foundation drains
f
--
_.-,.__.- -__ - -
Roof drains
City of 1agaa
Residential Sanitary Sewer Service
Compliance Inspection
Date CO6 /4:5 / f
i
Name
PID Number
4" to 6" Transition:
White Copy: Propeity Owner
House Number 7 _5? Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
Compliance
c°� foundation drain connection
! No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
a f No sump pump
Service Lateral Inspection Findings Number of stacks Entered S.L at e
Roots 22 ` , .5 , - -
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 2� ` f
,,,'
✓.
Of •�C7 rn
Time • p pm
Disk #
0
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:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
0
,'R Phone f' G /`v
I / t
% :
Notes
�✓ j� • < j
lime t� ® o pm
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet.
Final Cleanout:
O Access to service
lateral needed
O inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH