2098 Carnelian Lane - Inspection Formcity of Sala
Residential Sanitary Sewer Se rvice
Compliance Inspection
Date 07/ 2' d I / o
Name /0 0/9 . t 7 Disk #
P!D Number
House Number. 7' cif, Street Name
Alternative MailinggAddress,
For information call 65
Compliance
iir
No foundation drain connection
Q `' No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
lfr No sump pump
Service Lateral 1nspectio Findings Number of stacks I Entered S . at
Roots 6f
Poor Pipe Joints
Mineral Deposits �°`
Sag /Pipe Deflection
Damaged Pip
Transition
4" to 6" Transition:
& rte wnerlOccupant Signature
White Copy: Property Owner
Time � • o pm
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
YJ-LLf]
Record Number.
/ 1`f'^/ 76,v'
Length of Service:
Time
Obstruction
Unable to push past
feet
Notes
Final Cleanout:
cc
• L,/ d pm
Phone// - /
771
.
Inspect: Signature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
r efused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
s -
- --
--- •- ----- __"
Foundation drains
Roof drains
--
.....g_..._ - ..,
.y.s,.�.
city of Sala
Residential Sanitary Sewer Se rvice
Compliance Inspection
Date 07/ 2' d I / o
Name /0 0/9 . t 7 Disk #
P!D Number
House Number. 7' cif, Street Name
Alternative MailinggAddress,
For information call 65
Compliance
iir
No foundation drain connection
Q `' No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
lfr No sump pump
Service Lateral 1nspectio Findings Number of stacks I Entered S . at
Roots 6f
Poor Pipe Joints
Mineral Deposits �°`
Sag /Pipe Deflection
Damaged Pip
Transition
4" to 6" Transition:
& rte wnerlOccupant Signature
White Copy: Property Owner
Time � • o pm
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
YJ-LLf]
Record Number.
/ 1`f'^/ 76,v'
Length of Service:
Time
Obstruction
Unable to push past
feet
Notes
Final Cleanout:
cc
• L,/ d pm
Phone// - /
771
.
Inspect: Signature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
r efused
Yellow Copy: City of Eagan Pink Copy: SEH