3723 South Hills Way - Inspection FormMy Ili Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date f 1 r) I 2 2
Name
PID Number
House Number) Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
'Sump pit not connected to
;•, sanitary sewer
t(Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
/6/, /1
White Copy: Property Owner
Time
/7_4. 10 p m
Disk#
0
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 1 Entered S L at J 7
Record Number
/ /
Length of Service: I L /
/ O am
•
Time / • 42 d-pm
Phone [ (9 7 / /
Obstruction
Unable to push past
feet
/L
Notes
Final Cleanout: °r[. -t '
inspector Signature
Vi i" , '
9 � '`'
777
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
�� . t:/
PIPL=C65 e?ci —
/C f _e'Tf %c> ^' 7%' r!c: ; i
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
Mil IIII
My Ili Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date f 1 r) I 2 2
Name
PID Number
House Number) Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
'Sump pit not connected to
;•, sanitary sewer
t(Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
/6/, /1
White Copy: Property Owner
Time
/7_4. 10 p m
Disk#
0
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 1 Entered S L at J 7
Record Number
/ /
Length of Service: I L /
/ O am
•
Time / • 42 d-pm
Phone [ (9 7 / /
Obstruction
Unable to push past
feet
/L
Notes
Final Cleanout: °r[. -t '
inspector Signature
Vi i" , '
9 � '`'
777
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
�� . t:/
PIPL=C65 e?ci —
/C f _e'Tf %c> ^' 7%' r!c: ; i
Yellow Copy: City of Eagan Pink Copy: SEH