4777 Beacon Hill Rd - Inspection Form4 City or Ekan
Residential Sanitary Sewer Service
Compliance inspection
Date __I ' /
Name
PID Number
House Number
7 Y /
Alternative Mailing Address i � '2
Phone / ) �� 7 �._ � :c
I
._.. . --- - 177Z of
Owner /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
O No sump purnp
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
'
Transition
4" to 6" Transition:
White Copy: Property Owner
j •.E0 0 am
Time T. • ( ' pm
!? - Disk#
! Street Name
✓3
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 f Entered S L, at
Length of Service:
Yellow Copy: City of Eagan
/
Record Number
Time
1
1
/77,7' 7 0 am
• . °
• o pm
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
- Number
Correctly
Discharged
Incorrectly Unknown
Notes
L• .7 1J77
�� ,/.
,} a
r,
7 i t ^ - ` ' ,
J : 7r 11 . _!
Total
Sump pumps
',._,,r.
..
Foundation drains
MEI®
II
Roof drains
4 City or Ekan
Residential Sanitary Sewer Service
Compliance inspection
Date __I ' /
Name
PID Number
House Number
7 Y /
Alternative Mailing Address i � '2
Phone / ) �� 7 �._ � :c
I
._.. . --- - 177Z of
Owner /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
O No sump purnp
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
'
Transition
4" to 6" Transition:
White Copy: Property Owner
j •.E0 0 am
Time T. • ( ' pm
!? - Disk#
! Street Name
✓3
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 f Entered S L, at
Length of Service:
Yellow Copy: City of Eagan
/
Record Number
Time
1
1
/77,7' 7 0 am
• . °
• o pm
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH