3719 South Hills Lane - Inspection Form4 1111. City f lia a
Y � n
Residential Sanitary Sewer Service
Compliance Inspection
Date 9f' >"�! /' '
Name ! � ; Disk #
PID Number
House Number _Tr7I el Street Name
Alternative Mailing Address
`> A
Own /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
C ' No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Miner Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
C/ • i9 'am
Time • .�f p pm
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 e . im Entered S.L.at
Length of Service:
Yellow Copy: City of Eagan
r'f
Record Number
Time
4
• k2
•
-'7
Phone ; ; , s.
: } / ▪ /
1 '1n ;peetor Signature
Obstruction
Unable to push past
feet
y
r
O
.p am
o pm
No Access
::h4,441/ ,1
1
No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: ol1
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
, .Notes ...o V, 1,- ,=..4 / ��
.- - . ,,..7-
I 'l„.i F , �.i Llt.--
1
_
�1 . mo .. !
_
Total
pumps
v"
( ;
Foundation drains
✓
MI-
Roof drains
=
4 1111. City f lia a
Y � n
Residential Sanitary Sewer Service
Compliance Inspection
Date 9f' >"�! /' '
Name ! � ; Disk #
PID Number
House Number _Tr7I el Street Name
Alternative Mailing Address
`> A
Own /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
C ' No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Miner Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
C/ • i9 'am
Time • .�f p pm
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 e . im Entered S.L.at
Length of Service:
Yellow Copy: City of Eagan
r'f
Record Number
Time
4
• k2
•
-'7
Phone ; ; , s.
: } / ▪ /
1 '1n ;peetor Signature
Obstruction
Unable to push past
feet
y
r
O
.p am
o pm
No Access
::h4,441/ ,1
1
No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: ol1
Pink Copy: SEH