1569 Lancaster Lane - Inspection FormCity of Eapa
Residential Sanitary Sewer Service
Compliance Inspection
,." ,
Date �'': = ;1 �; ` l / ..
Name ! r`.,
PID Number
House Number
Alternative Mailing Address
r'
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to b" Transition:
White Copy: Pr operty Owner
rj <.r' ,, 9O)am
Time Imo,• '0 pm
Disk ##
( -1 Street Name
wnerlOccupant Signature
Non - Compliance
0
O
O
O
0
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:
Number Discharged
Sump pumps
Foundation drains
Roof drains
Total
71
Correctly
Incorrectly Unknown
Yellow Copy: City of Eagan
Q7
Record Number
i
Phone
Time
Obstruction
Unable to push past
feet
Entered 5.t at
Notes
• 0 am
• O pm
I
Inspector Signature
For information call 651.470.2788
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
./
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH