4787 Beacon Hill Rd - Inspection Forms41 ,0 1 ` . City or Eipl
Residential Sanitary Sewer Service
Compliance Inspection
Date d�F� I j('
f
Name
PID Number
House Number
Poor Pipe Joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
DISK
reet Name
Ow er cupant Signatur
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
f sanitary sewer
" X Sump pump properly piped
O No sump pump
Sag /Pipe Deflection
Damaged Pipe
4j,
Transition ' ". '
am
pm
Alternative Mailing Addrgss Phone
))
) 4cy,
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 statics Entered 5 L..at
Roots
Yellow Copy: City of Eagan
Record Number
1=4
Obstruction
Unable to push past
feet
/
Length of Service: / )� ? Final Cleanout: ,1- /
Notes
Time
inspector Signature
o am
X pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
cI;
Pink Copy: SEH
2
r -
2
Total
Number
Discharged
Correctly
incorrectly Unknown
Sump
1111111=
Im
MI
drains
Roof drains
41 ,0 1 ` . City or Eipl
Residential Sanitary Sewer Service
Compliance Inspection
Date d�F� I j('
f
Name
PID Number
House Number
Poor Pipe Joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
DISK
reet Name
Ow er cupant Signatur
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
f sanitary sewer
" X Sump pump properly piped
O No sump pump
Sag /Pipe Deflection
Damaged Pipe
4j,
Transition ' ". '
am
pm
Alternative Mailing Addrgss Phone
))
) 4cy,
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 statics Entered 5 L..at
Roots
Yellow Copy: City of Eagan
Record Number
1=4
Obstruction
Unable to push past
feet
/
Length of Service: / )� ? Final Cleanout: ,1- /
Notes
Time
inspector Signature
o am
X pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
cI;
Pink Copy: SEH
2
r -
2
Clty tit to °
Residential Sanitary Sewer Service
Compliance Inspection
Date r''
Name
PID Number
House Number Street Name ' ( // /Vie-
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks t Entered S,L at '�F ✓ " ✓ ;`'
' 1;.: )' r
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
• Oam
Time 4 • Jam? :EYpm
Disk #
OwnerlOccupant Signature
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Length of Service:
Yellow Copy: City of Eagan
Record Number "l!�
Time
Phone 'r. fr,
i 1
i
Inspector Signature -
Obstruction
Unable to push past
feet..
Final Cleanout:
• Q am
• 0 p
No Access
O No one in
IV Access to service
lateral needed
O Inspection
refused
Z .7- 7 --
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes s
. , , C., „4,-677"2:-11 ;r
4 `f 4/ ., , ,r --
Total
Sump pumps
i
Foundation drains
Ell
IIII
Roof drains
Clty tit to °
Residential Sanitary Sewer Service
Compliance Inspection
Date r''
Name
PID Number
House Number Street Name ' ( // /Vie-
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks t Entered S,L at '�F ✓ " ✓ ;`'
' 1;.: )' r
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
• Oam
Time 4 • Jam? :EYpm
Disk #
OwnerlOccupant Signature
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Length of Service:
Yellow Copy: City of Eagan
Record Number "l!�
Time
Phone 'r. fr,
i 1
i
Inspector Signature -
Obstruction
Unable to push past
feet..
Final Cleanout:
• Q am
• 0 p
No Access
O No one in
IV Access to service
lateral needed
O Inspection
refused
Z .7- 7 --
Pink Copy: SEH