3782 South Hills Ct - Inspection FormSump pumps
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Foundation drains
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Roof drains
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City Off' Fart ?n
Residential Sanitary Sewer Service
Compliance Inspection
Date l G 5 / f Time C s.�G' 0 pm
Name 2"f0 / M zr c`` Disk #
PID Number
House Number
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition /1
4" to 6" Transition:
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
4 No sump pump
White Copy: Property Owner
Street Name
/
Owner /Occupant Signature
LLB - [1J
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of n� stacks _ / Entered S.L.at 1
Roots
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
hone `ZS /9 e
/1
1 7
Notes
,r� C?
Time (r •
i1
' } inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout: s ,
ki
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
F
�am
0 pm
Pink Copy: SEH