4573 Lake Park Dr - Inspection FormCity of Cagan
Residential Sanitary Sewer Service
Compliance Inspection
•
Date I j I _ /
Name I V L ) r I / #
RID Number
House Number
i
Alterna ive,,Maili. gAddress
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No sump pump
White Copy: Property Owner
Time •
qam
�f •-, Street Name
` Owner /Occupant Signature
Service Lateral Inspection Findings
Non - Compliance
0
0
O
0
0
Number stacks
Length of Service:
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Time
7:
Phone _ Vii? _ _7
Obstruction
Unable to push past
feet
• O am
• o Pm
)
Inspector Signature
For information call 651.470.2788
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
ref used
Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SE H
Number Discharged
pnknown
Notes
y/ �_i
Total
Correctly
Incorrectly
Sump pumps
Lam` "_: ,-
Foundation drains
Roof drains
1-...� -
I
/
City of Cagan
Residential Sanitary Sewer Service
Compliance Inspection
•
Date I j I _ /
Name I V L ) r I / #
RID Number
House Number
i
Alterna ive,,Maili. gAddress
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No sump pump
White Copy: Property Owner
Time •
qam
�f •-, Street Name
` Owner /Occupant Signature
Service Lateral Inspection Findings
Non - Compliance
0
0
O
0
0
Number stacks
Length of Service:
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Time
7:
Phone _ Vii? _ _7
Obstruction
Unable to push past
feet
• O am
• o Pm
)
Inspector Signature
For information call 651.470.2788
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
ref used
Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SE H