4790 Beacon Hill Rd - Inspection Form4111
City of iapo
Residential Sanitary Sewer Service
Compliance Inspection
2 77
Date / ; -'r / • ?
r' t r •
Name .`° ? f /'
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
4" to 6" Transition:
�•,.
Service Lateral Inspection Findings
( 2 77 f t r
Roots
White Copy: Property Owner
Time •
1/2'; Disk#
PID Number
r
House Number �- '
' Street Name
Alternative Mailing Address
OwnerlOccupant Signature'
r d � 7 .[
Mineral Deposits _ `:� --� • `"—
Sag /Pipe Deflection
Damaged Pipe
Transition
p
m
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
Length of Ser vice:
, /
Record Number '
4
Time •
Phone / r L T/ "
inspector Signature
For information call 651.470.21n
Obstruction
Unable to push past
feet
Entered S L at
Notes
t L=
--� Final Cleanout: ,• ;,
7
••
' /
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
•
Yellow Copy: City of Pagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
!f ,
Foundation drains
Roof drains
i '
4111
City of iapo
Residential Sanitary Sewer Service
Compliance Inspection
2 77
Date / ; -'r / • ?
r' t r •
Name .`° ? f /'
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
4" to 6" Transition:
�•,.
Service Lateral Inspection Findings
( 2 77 f t r
Roots
White Copy: Property Owner
Time •
1/2'; Disk#
PID Number
r
House Number �- '
' Street Name
Alternative Mailing Address
OwnerlOccupant Signature'
r d � 7 .[
Mineral Deposits _ `:� --� • `"—
Sag /Pipe Deflection
Damaged Pipe
Transition
p
m
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
Length of Ser vice:
, /
Record Number '
4
Time •
Phone / r L T/ "
inspector Signature
For information call 651.470.21n
Obstruction
Unable to push past
feet
Entered S L at
Notes
t L=
--� Final Cleanout: ,• ;,
7
••
' /
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
•
Yellow Copy: City of Pagan Pink Copy: SEH