4781 Beacon Hill Rd - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
I an
Date
Name
PID Number
House Number
/ 3 /
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 pump
4" to 6" Transition:
White Copy: Property Owner
Time l
Owner /Occupant Signature
Disk #
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
o am
k pm
Street Name
Alternate Mailing Address
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number /311 3
!Sr 4C
Obstruction
Time
Unable to push past
feet
1j, ft f? t9
Inspector Signature
Final Cleanout:
o am
O pm
Phone (: ':J (�
For Information call 651.470.2788
No Access
o No one in
o Access to service lateral
needed
O inspection refused
. r
Entered S L. at k; .t-u .:. C I 0
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551
Total
Notes
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�:-
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Sum Pum s
Foundation Drains
Roof Drains
Residential Sanitary Sewer Service
Compliance Inspection
I an
Date
Name
PID Number
House Number
/ 3 /
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 pump
4" to 6" Transition:
White Copy: Property Owner
Time l
Owner /Occupant Signature
Disk #
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
o am
k pm
Street Name
Alternate Mailing Address
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number /311 3
!Sr 4C
Obstruction
Time
Unable to push past
feet
1j, ft f? t9
Inspector Signature
Final Cleanout:
o am
O pm
Phone (: ':J (�
For Information call 651.470.2788
No Access
o No one in
o Access to service lateral
needed
O inspection refused
. r
Entered S L. at k; .t-u .:. C I 0
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551
Resi Sanitary Sewer Service
Compliance Inspection
Date 7 /„9(....2 I /(
Name
PID Number
House Number
Time
Disk #
o am
o pm
Street Name
Alternate Mailingseddress Phone 1 c, /-1 ` 1
y
For Information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
oo Sump Pump properly piped
'Ne sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe__
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
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
C� s k u .c .
Length of Service:
Yellow Copy: City of Eagan
Record Number c lit 3
Obstruction
Unable to push past
feet
(eo
[_ Time
Inspector Signature
Ii Z
o am
o pm
No Access
o No one in
O Access to service lateral
needed
o Inspection refused
Entered S L at `
- )� Final Cleanout: 7 r '
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Total
Notes uur,_ \, 14,_ ?,,..d 4 t,
7 ^ 1 -u_ r �'
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Foundation Drains
Roof Drains
Resi Sanitary Sewer Service
Compliance Inspection
Date 7 /„9(....2 I /(
Name
PID Number
House Number
Time
Disk #
o am
o pm
Street Name
Alternate Mailingseddress Phone 1 c, /-1 ` 1
y
For Information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
oo Sump Pump properly piped
'Ne sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe__
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
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
C� s k u .c .
Length of Service:
Yellow Copy: City of Eagan
Record Number c lit 3
Obstruction
Unable to push past
feet
(eo
[_ Time
Inspector Signature
Ii Z
o am
o pm
No Access
o No one in
O Access to service lateral
needed
o Inspection refused
Entered S L at `
- )� Final Cleanout: 7 r '
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
4 City oI an
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 I / 17 1
Time
Name �s _! fi�f'I l Disk #
PID Number
House Number 'l Street Name l � ' 2 ,
Alternative MailingAddress
4" to 6 "Transition:
White Copy: Property Owner
OwnerlOccupant Signature
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 pump
• .4' (0 am
• _..� ,� p
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
rl Time
)
Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S,L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
ft
Final Cleanout:
• 0 a
• 0 pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged.
Notes i
),. ^_ ;/ ;J: — fug_
E
( 7-7
; t . ) < ''''fir `. -� ' 1
; ! j J J �. , !
Total
Correctly
Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
,i F — =: --!i �l t "Jfl F -4/ 1 ) %
4 City oI an
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 I / 17 1
Time
Name �s _! fi�f'I l Disk #
PID Number
House Number 'l Street Name l � ' 2 ,
Alternative MailingAddress
4" to 6 "Transition:
White Copy: Property Owner
OwnerlOccupant Signature
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 pump
• .4' (0 am
• _..� ,� p
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
rl Time
)
Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S,L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
ft
Final Cleanout:
• 0 a
• 0 pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH