1575 Lancaster Lane - Inspection Form4 111 City o Ea p
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date f
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
1 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
)7' p am
i / Time • ? pm
Name,✓ n ) f ? i / Disk #
PID Number
House Number ) ) 7 - Street Name )
Alternative Mailing Address
Owner /Occupant Signature
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
LLJ-[Ji
Phone
Yellow Copy: City of Eagan
Record Number
A
y ,
Time
Obstruction
Unable to push past
feet.
• Oam
• O pm
1
Inspector Signature ) i ) } ,/) ;Iv
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
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Final Cleanout:
Pink Copy: SEH
Y ��
Number Discharged
Unknown
Notes
-_-7 �,; _
Y <'� `` f
/ .., 1f " f ���' C " C -.� /.__ ., < C � .."' -
$ i 1 . .
, ,
77-217-7--5T/16;) f_ W ' � A Ic."
C qtr` ; ,-- = '. .7" ,c. 71 rr f
Total
Correctly
Incorrectly
Sump pumps
,
-
r '
I
Foundation drains
Roof drains
1 __
4 111 City o Ea p
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date f
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
1 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
)7' p am
i / Time • ? pm
Name,✓ n ) f ? i / Disk #
PID Number
House Number ) ) 7 - Street Name )
Alternative Mailing Address
Owner /Occupant Signature
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
LLJ-[Ji
Phone
Yellow Copy: City of Eagan
Record Number
A
y ,
Time
Obstruction
Unable to push past
feet.
• Oam
• O pm
1
Inspector Signature ) i ) } ,/) ;Iv
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
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Final Cleanout:
Pink Copy: SEH
Y ��