1397 Camelback Dr - Inspection Form4111
City of hp
Residential Sanitary Sewer Service
Compliance Inspection
„
Date A
Name J ----,
RID Number
House Number
/ 0 Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
- • Disk #
Time 6 pm
Street Name
-m-
Alternative Mailing Address
A , A A -
Owner/Occupant Signature
For information call 651A70.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Service Lateral Inspection Findings
11.
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
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Length of S erv i ce:
Yellow Copy: City of Eagan
Record Number
H Time
(1...." ( -2 0
Phone -
Inst;ector Signature 1 i/11 , •
Obstruction
Unable to push past
feet
0 am
•
• 0 Pm
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
re
Entered S L at
Pink Copy SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
/,.......;,-. y
,..
- --..),-. r -..'""-- . )
i
.... 3 -- 1 ' M ..- ..? . f:::,
, ..,
e- --'- . - i
Total
Sump pumps
4
/7
' ,
N )
"v
A
Foundation drains
Roof drains
)
. .
.. /
V
'',
4111
City of hp
Residential Sanitary Sewer Service
Compliance Inspection
„
Date A
Name J ----,
RID Number
House Number
/ 0 Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
- • Disk #
Time 6 pm
Street Name
-m-
Alternative Mailing Address
A , A A -
Owner/Occupant Signature
For information call 651A70.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Service Lateral Inspection Findings
11.
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
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Length of S erv i ce:
Yellow Copy: City of Eagan
Record Number
H Time
(1...." ( -2 0
Phone -
Inst;ector Signature 1 i/11 , •
Obstruction
Unable to push past
feet
0 am
•
• 0 Pm
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
re
Entered S L at
Pink Copy SEH