3727 South Hills Way - Inspection FormCity of tan
Residential Sanitary Sewer Service
Compliance Inspection
Date` . i / � ,f 1 1 /
Name
C -.'Cry am
Time pm
Disk #
PID Number
_.
House Number Street Name
Alternative Mailing Address
or� pliance
No foundation drain connection
,9 , No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ; �� 1 <9
4" to 6" Transition: r '
White Copy: aPtoper ty Owner
•
/Owner/Occupant Signature
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
i
Length of Service:
Yellow Copy: City of Eagan
Record Number
For information call 651 47
Obstruction
Unable to push past
feet
ime
i 2 .,2C o t ,am
` pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks _ -/ Entered S at _,
Roots
Final Cleanout:
Pink Copy: SEH
Total
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
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Sump pumps
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Foundation drains
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Roof drains
City of tan
Residential Sanitary Sewer Service
Compliance Inspection
Date` . i / � ,f 1 1 /
Name
C -.'Cry am
Time pm
Disk #
PID Number
_.
House Number Street Name
Alternative Mailing Address
or� pliance
No foundation drain connection
,9 , No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ; �� 1 <9
4" to 6" Transition: r '
White Copy: aPtoper ty Owner
•
/Owner/Occupant Signature
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
i
Length of Service:
Yellow Copy: City of Eagan
Record Number
For information call 651 47
Obstruction
Unable to push past
feet
ime
i 2 .,2C o t ,am
` pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks _ -/ Entered S at _,
Roots
Final Cleanout:
Pink Copy: SEH