4625 Beacon Hill Rd - Inspection Formlb- •
My of Ealao
Residential Sanitary Sewer Service
Compliance Inspection
Date / )1 Time
Name_
PID Number
House Number
Alternative Mailing Address
Owner/Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Sag/Pipe Deflection
Damaged Pipe
Transition L--/—
4" to 6"Transition:
White Copy: Proper ty Owner
Disk #
Street Name
Number of stacks
Poor Pipejoints -; 7.
Phone
Non
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
Mineral Deposits
L 2L
Yellow Copy: City of Eagan
Record Number
Time •?•
pm
/ / inspector Signature
Obstruction
Unable to push past
feet.
Entered St at )
No Access
O No one in
▪ ,
Et?
For information caIl 651.470.2788
O Access to service
lateral needed
O Inspection
refused
)
/ -
Length of Service: V71) Final Cleanout: . •)
Pink Copy: SETT
Number
Correctly
Discharged
Incorrectly Unknown
Notes. ,-,
-,', .4- , 1 ,....„/,' ! _.:::.,--;. -.;(')/) ,-,,. -...-._`-',,(
,-, ) ,)
) r
1 ., „.
Total
Sump pumps
4
Foundation drains
Roof drains
.--,
- }
;......„..'
lb- •
My of Ealao
Residential Sanitary Sewer Service
Compliance Inspection
Date / )1 Time
Name_
PID Number
House Number
Alternative Mailing Address
Owner/Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Sag/Pipe Deflection
Damaged Pipe
Transition L--/—
4" to 6"Transition:
White Copy: Proper ty Owner
Disk #
Street Name
Number of stacks
Poor Pipejoints -; 7.
Phone
Non
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
Mineral Deposits
L 2L
Yellow Copy: City of Eagan
Record Number
Time •?•
pm
/ / inspector Signature
Obstruction
Unable to push past
feet.
Entered St at )
No Access
O No one in
▪ ,
Et?
For information caIl 651.470.2788
O Access to service
lateral needed
O Inspection
refused
)
/ -
Length of Service: V71) Final Cleanout: . •)
Pink Copy: SETT