4722 Beacon Hill Rd - Inspection FormCity of Fa n
p
Residential Sanitary Sewer Service
Compliance Inspection
Date.
Name
PID Number
House Number - Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
, pump properly piped
O No sump pump
Service Lateral inspection Findings
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition %' 477
4" to 6 "Transition:
White Copy: Property Owner
• - -- p am
Time a • pm
Disk #
awner E p t Signature
(7
1
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
Yellow Copy: City of Eagan
Record Number
Time
Number of stacks I Entered S..L..at
• ' o am
7) • �Pm
J
Phone /< 1 / - -'S ,C
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
n
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
1
Length of Service: Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Not /�}
) -/';69. J/ ! } 'C r� f !`" - >; i 'l
d
-- ,I r).x° ;10
� '
J( /� r / mo �}'i r'
L 1 `,:Y r e ®mr 6../2'..',7
../ 2.. c S <<:;)i
t
Total
Sump pumps
r`1
Foundation drains
Roof drains
%,
City of Fa n
p
Residential Sanitary Sewer Service
Compliance Inspection
Date.
Name
PID Number
House Number - Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
, pump properly piped
O No sump pump
Service Lateral inspection Findings
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition %' 477
4" to 6 "Transition:
White Copy: Property Owner
• - -- p am
Time a • pm
Disk #
awner E p t Signature
(7
1
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
Yellow Copy: City of Eagan
Record Number
Time
Number of stacks I Entered S..L..at
• ' o am
7) • �Pm
J
Phone /< 1 / - -'S ,C
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
n
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
1
Length of Service: Final Cleanout:
Pink Copy: SEH