2054 Carnelian Lane - Inspection Forms! 3
City o
Residential Sanitary Sewer Service
Compliance Inspection
Dated ix / / l 1 Time
Name
TT 72,
PID Number
House Number „<'°,7,,,),)-) 4 Street Name
Alternative Mailing Address
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump property piped
O No sump pump
/ Disk #. rjj
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Pro perty Owner
• % am
!O pm
Non - Compliance
O
O
O
O
O
LLJ-W
Length of Service:
Yellow Copy: City of Eagan
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Time
Number of stacks _ Entered S L at
Obstruction
Unable to push past
feet
Phone _ 6. .7 ^.�' > .._
Inspector Signature
For information call 651.470.2788
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
•
• __ O pm
No Access
0 No one in
C'
0 am
Access to service
_Laval need
0 inspection
r efused
Pink Copy: SEH
C L)
ri
Number Discharged
ote5
,:
) 1 ! � t %L
'-fir .,L -4-T ( , l '.) -: � ,,,
, ._ ,. --' ' -_ ,L j
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
! 3
City o
Residential Sanitary Sewer Service
Compliance Inspection
Dated ix / / l 1 Time
Name
TT 72,
PID Number
House Number „<'°,7,,,),)-) 4 Street Name
Alternative Mailing Address
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump property piped
O No sump pump
/ Disk #. rjj
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Pro perty Owner
• % am
!O pm
Non - Compliance
O
O
O
O
O
LLJ-W
Length of Service:
Yellow Copy: City of Eagan
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Time
Number of stacks _ Entered S L at
Obstruction
Unable to push past
feet
Phone _ 6. .7 ^.�' > .._
Inspector Signature
For information call 651.470.2788
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
•
• __ O pm
No Access
0 No one in
C'
0 am
Access to service
_Laval need
0 inspection
r efused
Pink Copy: SEH
C L)
ri
Residential Sanitary Sewer Service'
Compliance Inspection
Time g
Disk # ]-
PID Number
House Number Street Name 4./Z7
Date i27/ / /a
Name r e7f; ?--
Alternative Mailing Address
4" to 6" Transition:
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
White Copy: PI oper ty Owner
/Owner/Occupant Signature
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
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
Phone (
,
/41,/,
. Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks__ Entered S L at
Roots
Notes
7 /
Final Cleanout:
7')
•
• 0 Pm
No Access
O No one in
0 am
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Number
Discharged
Corr ectly
incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service'
Compliance Inspection
Time g
Disk # ]-
PID Number
House Number Street Name 4./Z7
Date i27/ / /a
Name r e7f; ?--
Alternative Mailing Address
4" to 6" Transition:
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
White Copy: PI oper ty Owner
/Owner/Occupant Signature
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
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
Phone (
,
/41,/,
. Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks__ Entered S L at
Roots
Notes
7 /
Final Cleanout:
7')
•
• 0 Pm
No Access
O No one in
0 am
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH