3771 South Hills Dr - Inspection FormCity of a i
Residential Sanitary Sewer Service
Cornphlance Inspection
Date ).Z4
Name
PID Number
House Number
Alternative Mailing Address
4 , h
V � � Owner /Occupant Signature
For information call 651;470.2788
Compliance
4t
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
A l No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ;
4" to 6" Transition
i
White Copy: Property Owner
Time
Disk#
7 I Street Name
7
/ • ° am
• A pm
)r
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 _
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone /- ''..
Inspector Signature
Obstruction
Unable to push past
feet
1 CI
�
L - :
.
-Final Cleanout:
l am
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Entered SL at
r
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
° °
Foundation drains
; i
Roof drains
f '
City of a i
Residential Sanitary Sewer Service
Cornphlance Inspection
Date ).Z4
Name
PID Number
House Number
Alternative Mailing Address
4 , h
V � � Owner /Occupant Signature
For information call 651;470.2788
Compliance
4t
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
A l No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ;
4" to 6" Transition
i
White Copy: Property Owner
Time
Disk#
7 I Street Name
7
/ • ° am
• A pm
)r
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 _
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone /- ''..
Inspector Signature
Obstruction
Unable to push past
feet
1 CI
�
L - :
.
-Final Cleanout:
l am
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Entered SL at
r
Pink Copy: SEH