4622 Beacon Hill Rd - Inspection Form
Residential Sanitary Sewer Service
E r~r Ompliance Inspection
~ • f ~.f~am
Date w 11 i Time pm Record Number
Time if • pm
( _ / •
PID Number
House Number ~ L-7~9,L, Street Name r ~ ~f7!'?%~ ~i l J f~
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Alternet'ive Mailing Address Phone
"'or Signature
Owr/Occupant Signature Inspect
! information call 651.410.2788
For Compliance Non-Compliance Obstruction No Access
No foundation drain connection O Clear' water connections to Unable to push past O No one in
No roof drain connection sanitary sewer feet O Access to service
O Service lateral defects lateral needed
Sump pit not connected to 0 Defective manholes
sanitary sewer O Inspection
O Sump pump connected to sanitary refused
O Sump pump properly piped sewer
O No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S. L at-?/cTf_l~✓
Roots L- Z41 Z_ - -
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
-422 4-9 77
Transition 14-
- as -tip ~ ~
4" to 6" Transition: Length of Service: 1 Final Cleanout:
Notes
Number Discharged.
Total Correctly Inccorreectllyyf Unknown
Sump pumps ,5 { iti r r
~I`3 t /r
Foundation drains
Roof drains
White Copy: Piopei ty Owner Yellow Copy: City of Pagan Pink Copy: SFH