1584 Lancaster Lane - Inspection Form'
Number Discharged
Correctly Incorrectly Unknown
Mill --
MEM
N otes -- t✓'v/ ;r)! " 4. - Li,' c 7
'- i .,----/' ' I' r JS f ` C - i /A c. r1 %` } / '.t ; 5r
i
1 rtlX : // � ..
Total
Sump pumps
,
Foundation drains
Roof drains)
—.... '
4 111. City of two
Residential Sanitary Sewer Service
Compliance Inspection
Date !01' /
Name . i /7 f T7A #
PID Number
House Number
Alternative MaiiipgAd
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
ess
1
nerlgcOpant Signature
1
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
/
Transition �J
4" to 6 "Transition:
White Copy: Pr operty Owner
j •, oam
Time • ‘/U if pm
0
—(1 Street Name - 4 / f7 z
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 I Entered S.L.at J7`� ".°
•
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
rT
• 7 7 0 am
• t pE pm
Phone 67) - 6
•
inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: V /tat,:
Pink Copy: SEH