1948 Carnelian Lane - Inspection FormCity o I • Afa ii
Residential Sanitary Sewer Service
Compliance Inspection
y
Date C!J / ) ? i ) Time
i
Name / , (f /6f'
PID Number
House Number
Alternative Mailing Address
Compliance
$ No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump purrip
Poor Pipe Joints
Mineral Deposits
(Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition: fr
White Copy: Pr oper ty Owner
Disk #
Owner /Occupant Signature
fl
• 00 am
• pm
t
Length of Service:
Number Discharged
Sump pumps
Foundation drains
Roof drains
Total
. 4
Correctly Incorrectly Unknown
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
Record Number
C y Time ) T : `r — / pm
1
Street Name � / ir )/ I j
Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks I Entered S.L. at
Roots 7,-; , }
1
1 Final Cleanout:
Notes
U —' itI
No Access
O No one in
O Access to service
lateral needed
O Inspection ..
refused
Yellow Copy: City of Eagan Pink Copy: SEH