3763 South Hills Dr - Inspection Form1 111 1 .
City of Fag,an Residential Sanitary Sewer Service
C.onripliance Inspection
Date n'Y/ 6
Name (7-2 (1/4:44 - 4/ Disk #
PO Number
House Number.
Damaged Pipe
Transition
4" to 6" T ansition:
Alternative Mailing Address
White Copy: Property Owner
Time ( - 7 4 opm
Street Name
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Non-Compliance
m-
Recorcl Number
•
77 /
o
am
•
Time • 0 pm
• Pone .(ec-->")
/1
. /
//I
, : VI v rispector Signature
For information call 651.470.2788
Obstruction
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Ser Lateral Inspection Findings Number of stacks W Entered S L at
Roots
Poor Pipe Joints - c1. - ) r / .- , ') / '-- 11 ,Ai
i), .,.,-.(., ),--41i -7-7:a 4 . „.., . .. /_) L" /0:(5,{ 2
, i
I( /CP /. <7 /v c; i 7),-. /(i / 7' p: o e "-'2p, ,72 , (.31,0 / 5
. /
Mineral Deposits
...
Sag/Pipe Deflectio - 17 - -PC - /7)(_ ),-vf:.]:., * 1:14, 7 4:e .- Ailit -7 •
,./ ;-:,- ,- / r'-- /1...../7 -F-7,:::7, ..,:r.l.
Length of Service: Final Cleanout:
k
No Access
O No one in
Notes
(77 .
ICA
Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Cor rectly
Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
1 111 1 .
City of Fag,an Residential Sanitary Sewer Service
C.onripliance Inspection
Date n'Y/ 6
Name (7-2 (1/4:44 - 4/ Disk #
PO Number
House Number.
Damaged Pipe
Transition
4" to 6" T ansition:
Alternative Mailing Address
White Copy: Property Owner
Time ( - 7 4 opm
Street Name
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Non-Compliance
m-
Recorcl Number
•
77 /
o
am
•
Time • 0 pm
• Pone .(ec-->")
/1
. /
//I
, : VI v rispector Signature
For information call 651.470.2788
Obstruction
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Ser Lateral Inspection Findings Number of stacks W Entered S L at
Roots
Poor Pipe Joints - c1. - ) r / .- , ') / '-- 11 ,Ai
i), .,.,-.(., ),--41i -7-7:a 4 . „.., . .. /_) L" /0:(5,{ 2
, i
I( /CP /. <7 /v c; i 7),-. /(i / 7' p: o e "-'2p, ,72 , (.31,0 / 5
. /
Mineral Deposits
...
Sag/Pipe Deflectio - 17 - -PC - /7)(_ ),-vf:.]:., * 1:14, 7 4:e .- Ailit -7 •
,./ ;-:,- ,- / r'-- /1...../7 -F-7,:::7, ..,:r.l.
Length of Service: Final Cleanout:
k
No Access
O No one in
Notes
(77 .
ICA
Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH