3770 South Hills Ct - Inspection FormSump pumps,
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Foundation drains
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Roof drains
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City fll taGau
Residential Sanitary Sewer Service
Compliance Inspection
Date !2/i 7 ! f
Name j i'rI
PID Number
House Number
Alternative Mailing Address
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
Service Lateral Inspection Findings
4" to 6 "Transition:
`,� • / o am
Time t ') • /` pm
Disk #
Street Name
Owner /Occupant Signature
j
1
For information call 651
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. Entered S..l_..at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
White Copy: Pr operty Owner
Record Number
o am
Time / • / 15 pm
Phone
Obstruction
Unable to push past
Ft feet
r '
,inspector Signature
Final Cleanout:
Notes -ti... ' l r(6
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r j ; �f�� /`�r� f��
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
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