1587 Lancaster Lane - Inspection FormCity aC Fag
Residential Sanitary Sewer Service
Compliance Inspection
Dated 1 / 1 10
r s 3�1. : z
Name
PID Number
House Number 1 / Street Name
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
4" to 6" Transition:
White Copy: Property Owner
Time / • 'o pm
n
Disk
OwnerlOccupant Signature
Non - Compliance
0
O
O
O
0
Length of Service:
Yellow Copy: City of Eagan
Record Number
Alternative Mailing Address Phone
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Time
Obstruction
Unable to push past
feet
•
•
Inspector Signature
Final Cleanout:
0 am
O Pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number Discharged
Unknown
Notes
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Total
Correctly
Incorrectly
Sump pumps
Foundation drains
Roof drains
City aC Fag
Residential Sanitary Sewer Service
Compliance Inspection
Dated 1 / 1 10
r s 3�1. : z
Name
PID Number
House Number 1 / Street Name
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
4" to 6" Transition:
White Copy: Property Owner
Time / • 'o pm
n
Disk
OwnerlOccupant Signature
Non - Compliance
0
O
O
O
0
Length of Service:
Yellow Copy: City of Eagan
Record Number
Alternative Mailing Address Phone
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Time
Obstruction
Unable to push past
feet
•
•
Inspector Signature
Final Cleanout:
0 am
O Pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH