3740 South Hills Dr - Inspection FormCity of Ca pa
Residential Sanitary Sewer Service
Compliance Inspection
2 ,
Date 1 i' ! Time
Name
PID Number
House Number
Alter native Mailing Address
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
/Sump pump properly piped
O No sump pump
OwnerlOccupant Signature_
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 ��
e_
4" to 6 "Transition:
White Copy: Property Owner
O
r y , • pm
Disk ##
Street Name
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
'7 (_ 9 Time _ • pm
e`1 !�
Phone lr? �S
inspector
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S at
f (2 +TY j .... /7
( Final Cleanout:
Pink Copy; SEH
Notes
l ' I L.
! 7
/` o `
LAY/
r I l
-_,-,'r
---",77
'
:' .1 1 .x .
'
7 : -'e /
Number
Correctly
Discharged.
Incorrectly
Unknown
Total
Sump pumps
1
/
f
Foundation drains
Roof drains
j '
City of Ca pa
Residential Sanitary Sewer Service
Compliance Inspection
2 ,
Date 1 i' ! Time
Name
PID Number
House Number
Alter native Mailing Address
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
/Sump pump properly piped
O No sump pump
OwnerlOccupant Signature_
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 ��
e_
4" to 6 "Transition:
White Copy: Property Owner
O
r y , • pm
Disk ##
Street Name
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
'7 (_ 9 Time _ • pm
e`1 !�
Phone lr? �S
inspector
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S at
f (2 +TY j .... /7
( Final Cleanout:
Pink Copy; SEH