2105 Carnelian Lane - Inspection FormResidential Sanitary Sewer Service
�N�m�
City � Compliance -
vx� or
Date - /
Name
Number
House Number
Compliance
n
o
o
Transition
White Copy: Property Owner
Time
Disk#
Signature
No foundation drain connection
No roof dram connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflecti '� on �) .
Damaged Pipe
4" to 6" Transition:
Non
o Clear water connections to
sanitary sewer
n Service lateral defects
o Defective manholes
✓ Sump purnp connected to
sanitary sewer
o Flexible sump pump piping
o am
• pm
Street Name
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Obstruction
/1 /
Record Number c»/�/
Time
l
�4/ .� ~`
Alternate Address Phone
- /^
�, �`� ;'n
Inspector Signature
Unable to push pas
o~ feet
Entered S L at )u.�
o am
o pm
For Information call 651.470.2788
No Access
n Nn one in
o
Access 10 service lateral
needed
o Inspection refused
Final Cleanout:
Pink Copy Benjamin Franklin Plumbing
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Foundation Drains
Roof Drains
Residential Sanitary Sewer Service
�N�m�
City � Compliance -
vx� or
Date - /
Name
Number
House Number
Compliance
n
o
o
Transition
White Copy: Property Owner
Time
Disk#
Signature
No foundation drain connection
No roof dram connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflecti '� on �) .
Damaged Pipe
4" to 6" Transition:
Non
o Clear water connections to
sanitary sewer
n Service lateral defects
o Defective manholes
✓ Sump purnp connected to
sanitary sewer
o Flexible sump pump piping
o am
• pm
Street Name
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Obstruction
/1 /
Record Number c»/�/
Time
l
�4/ .� ~`
Alternate Address Phone
- /^
�, �`� ;'n
Inspector Signature
Unable to push pas
o~ feet
Entered S L at )u.�
o am
o pm
For Information call 651.470.2788
No Access
n Nn one in
o
Access 10 service lateral
needed
o Inspection refused
Final Cleanout:
Pink Copy Benjamin Franklin Plumbing
Residential Sanitary Sewer Service
Compliance . nspection
oEa o:
Date 0 /PG / 1 c
Name r c�,
P]D Number
House Number
r
Owner /Occupant Signature
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump Pump properly piped
No sump pump
Time
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
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
Disk #
O am
O pm
Street Name
Length of Service:
Yellow Copy: City of Eagan
Record Number c9 ? ,
Obstruction
Time
•
Alternate Mailing Address Phone = ! � - -
)
For Information call 651.470.2788
Unable to push past
feet
l~.'
inspector Signature
. \ 4 . ` -
O am
O pm
No Access
O No one in
O Access to service lateral
needed
O Inspection refused
Number of stacks Entered S L at -- 7 , te. F - , / 1 I,, j
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection (
Damaged Pipe
Transition
Final Cleanout: /3
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551
Number
Correctly
Discharged
Incorrectly
(Unknown
Notes = „�, . -_
r
-}„,, / j e. ,
a , c l,. ! J (c,...._',1,2) �
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` ti1' „ N r P ; `a '' j
.3
d _ - ft
` r , �n ST - .1,. c �� ..
..s~�. 4.�,. �
C!"" �- 1
Total
Sump Pumps
Foundation Drains
G.6
IIII
Roof Drains
---
Residential Sanitary Sewer Service
Compliance . nspection
oEa o:
Date 0 /PG / 1 c
Name r c�,
P]D Number
House Number
r
Owner /Occupant Signature
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump Pump properly piped
No sump pump
Time
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
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
Disk #
O am
O pm
Street Name
Length of Service:
Yellow Copy: City of Eagan
Record Number c9 ? ,
Obstruction
Time
•
Alternate Mailing Address Phone = ! � - -
)
For Information call 651.470.2788
Unable to push past
feet
l~.'
inspector Signature
. \ 4 . ` -
O am
O pm
No Access
O No one in
O Access to service lateral
needed
O Inspection refused
Number of stacks Entered S L at -- 7 , te. F - , / 1 I,, j
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection (
Damaged Pipe
Transition
Final Cleanout: /3
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551