3785 South Hills Dr - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date / / C'
Name ° / ' 1 j4 - t/S a Disk #
PJD Number
House Number - /' e Street Name
Alternative Mailing Address
For information call 551.470 2788
Compliance
40 No foundation drain connection
No roof drain connection
I1" Sump pit not connected to
sanitary sewer
VSump pump properly piped
0 No sump pump
'i�v f,
Owner/Occupant Signature
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection 4 ' f m_
Damaged Pipe
Transition L.
4" to 6 "Transition:
Sump pumps
Foundation drains
Roof drains
(;f J\
White Copy: Property Owner
Time Or? j 2 O m
Non - Compliance
O Clear• water connections
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
c
Total Correctly
e X
Try
Number of stacks . ( Entered S L.at
Length of Service:
Number Discharged
Incorrectly
to
Unknown
Yellow Copy: City of Eagan
j
Record Number_
;'Inspector Signature
Obstruction
Unable to push past
feet
rr l • /e � ]'am
Time / • O pm
No Access
0 one in
O Access to service
lateral needed
O Inspection
refused
Final Cieanout:�,
Notes .! s
/
I ; Gi
_.a
Pink Copy: SEH