1370 Camelback Dr - Inspection Form4 111. City of Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date / / / /LI)
Name
MD Number
House Number
•
Warn
Time •
r Disk #
2
_ Th 7/ Street Name
Owner/Occupant Signature
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
OXSump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Later al Inspection Findings
Roots
4" to 6"Transition:
White Copy: Property Owner
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
/
Phone
Time
•
•
p,
)
Final Cleanout:
o am
o pm
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SF H
Number
Correctly
Discharged
incorrectly
Unknown
Notes
. , --•
(_-/-:----.-..-.-_:.--- '
. /
....- ''.,? -.---;;',;--- A 4,
— z i ..,- ,.. <: ,.."
, • l /))' - 7 1 .,.. -"1-"":.:---_,-1,..?.- ,44,...,„7„,,,..--;.../.
2 /...2
r _
Total
Sump pumps
l /--) '
1
?"-'' . 7 ''-'
'
,.e„."
7Y 17
Foundation drains
11111 7
Roof drains
_
- .7
_...)
4 111. City of Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date / / / /LI)
Name
MD Number
House Number
•
Warn
Time •
r Disk #
2
_ Th 7/ Street Name
Owner/Occupant Signature
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
OXSump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Later al Inspection Findings
Roots
4" to 6"Transition:
White Copy: Property Owner
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
/
Phone
Time
•
•
p,
)
Final Cleanout:
o am
o pm
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SF H