2055 Carnelian Lane - Inspection FormCity of boo
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 1 f 1 # 6) _
Name J l /T ) >! Disk #
PID Number
<27) /..771-7 �treet Name
House Number
Alter native Mailing Address
Owner /Occupant Signature
For information call 651,.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
; O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
8 No sump pump
Service Lateral Inspection Findings
Roots -
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Pi oper ty Owner
Time � s
am
pm
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
Number of stacks _ 1
Time
Record Number
a
am
pm
t ) r
Phone fir ; - ` -
1
/ , ✓ t-.
._.'.
Length of Service: ( 7:75
Obstruction
Unable to push past
feet
Notes
Inspector Signature
Entered S.L at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
A
Final Cleanout: 6/1 `) f 1''M
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
,/
Foundation drains
Roof drains
City of boo
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 1 f 1 # 6) _
Name J l /T ) >! Disk #
PID Number
<27) /..771-7 �treet Name
House Number
Alter native Mailing Address
Owner /Occupant Signature
For information call 651,.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
; O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
8 No sump pump
Service Lateral Inspection Findings
Roots -
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Pi oper ty Owner
Time � s
am
pm
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
Number of stacks _ 1
Time
Record Number
a
am
pm
t ) r
Phone fir ; - ` -
1
/ , ✓ t-.
._.'.
Length of Service: ( 7:75
Obstruction
Unable to push past
feet
Notes
Inspector Signature
Entered S.L at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
A
Final Cleanout: 6/1 `) f 1''M
Yellow Copy: City of Eagan Pink Copy: SEH