4794 Beacon Hill Rd - Inspection Form. Cif of 1d a
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date, / -I 1t /
Name U T Disk #
/ 'p am
Time f pm
Alter•native Mailing Address
4" to 6 "Transition:
White Copy: Propel ty Owner
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
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
Service Lateral Inspection Findings Number of stacks
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
ii
Transition
c A 71
Yellow Copy: City of Eagan
Record Number `J
• '20 • am
me • pm
HD Number
House Number 4- street Name r
Phone �., " � � 1 7
r _
Inspector Signature
Obstruction
Unable to push past
feet
For information call 651.4701788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
}
.n
--7
Entered S L.at 477_2 ; - _
L
Length of Service: / )() 424- Final Cleanout: r' L i
Pink Copy: SEH
Total
Number
Correctly -
Discharged
Incorrectly
Unknown
Notes
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f'
; J` t i i r
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I
Sump pumps
'c�
Foundation drains
IIM
Roof drains
. Cif of 1d a
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date, / -I 1t /
Name U T Disk #
/ 'p am
Time f pm
Alter•native Mailing Address
4" to 6 "Transition:
White Copy: Propel ty Owner
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
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
Service Lateral Inspection Findings Number of stacks
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
ii
Transition
c A 71
Yellow Copy: City of Eagan
Record Number `J
• '20 • am
me • pm
HD Number
House Number 4- street Name r
Phone �., " � � 1 7
r _
Inspector Signature
Obstruction
Unable to push past
feet
For information call 651.4701788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
}
.n
--7
Entered S L.at 477_2 ; - _
L
Length of Service: / )() 424- Final Cleanout: r' L i
Pink Copy: SEH