1581 Lancaster Lane - Inspection FormCity of 1 a a
Residential Sanitary Sewer Service
Compliance Inspection
Date � i
/1/7'") /
Name
ND Number
House Number
/ '} j Street Name
Alternative MilingAddess s l ti
1 i \ /. \
1 !
4
\ 4j J Own r. eapant Signature
For information call 651:470 2788
Compliance
O No foundation drain connection
• No roof drain connection
+1 k
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
:7 '�
• O pm
i- LL1- L1 J
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
Length of Service:
Yellow Copy: City of Eagan
r
Record Number
Notes
Time
Phone
Obstruction
Unable to push past
feet
Entered S L at
• 0 am
• o pm
h`rspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
"/7 ..
�� �1
Pink Copy: SEH
Nunsber
Correctly
Discharged
Incorrectly Unknown
Total
Sump pumps
P P P
fz
;
,„_.....,__
1
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tr f • --
` rF f)
y
r
Foundation drains
Roof drains
City of 1 a a
Residential Sanitary Sewer Service
Compliance Inspection
Date � i
/1/7'") /
Name
ND Number
House Number
/ '} j Street Name
Alternative MilingAddess s l ti
1 i \ /. \
1 !
4
\ 4j J Own r. eapant Signature
For information call 651:470 2788
Compliance
O No foundation drain connection
• No roof drain connection
+1 k
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
:7 '�
• O pm
i- LL1- L1 J
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
Length of Service:
Yellow Copy: City of Eagan
r
Record Number
Notes
Time
Phone
Obstruction
Unable to push past
feet
Entered S L at
• 0 am
• o pm
h`rspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
"/7 ..
�� �1
Pink Copy: SEH