3755 South Hills Dr - Inspection Formc.f\pi
Residential Sanitary Sewer Service
4 Q I�1apn Com liance Insection
P Inspection
• d'am
Date (5":"..r/ Z /t Time 0 ✓ • ("a o pm
Name . JU[ t Disk #
0a7//
l� —
PID Number
House Number 7 i Street Name
f l ...,v"
Owt r!Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O
O
O
0
0
Record Number
Alternative Mailing Address Phone
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
)13 4-
Yellow Copy: City of Eagan ;
Obstruction
Unable to push past
feet
• clam
Time ( • rJ o' pm
/ Inspector Signature
For information call 651.470.2788
Number of stacks / Entered S. L. at 7Y ;>rt
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition L, / /
Final Cleanout:
Notes — // / :yw �.
7 . J -r r;�-F-? J il
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
-IN
MOM
Foundation drains
Roof drains
c.f\pi
Residential Sanitary Sewer Service
4 Q I�1apn Com liance Insection
P Inspection
• d'am
Date (5":"..r/ Z /t Time 0 ✓ • ("a o pm
Name . JU[ t Disk #
0a7//
l� —
PID Number
House Number 7 i Street Name
f l ...,v"
Owt r!Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O
O
O
0
0
Record Number
Alternative Mailing Address Phone
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
)13 4-
Yellow Copy: City of Eagan ;
Obstruction
Unable to push past
feet
• clam
Time ( • rJ o' pm
/ Inspector Signature
For information call 651.470.2788
Number of stacks / Entered S. L. at 7Y ;>rt
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition L, / /
Final Cleanout:
Notes — // / :yw �.
7 . J -r r;�-F-? J il
Pink Copy: SEH