4715 Beacon Hill Rd - Inspection Forms411111111* C itpti v o
Residential Sanitary Sewer Service
Compliance Inspection
Date
, /?
/
Name -
House Number
Alternative Mailing Address
i - • •
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
Service Lateral inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Owner
.1 • • )4 am
Time Le • /0 pm
Disk #
MD Number
OwnerlOccupant Signature
. Street Name
/
Phone (.<:' L 7) —
/
For information call 651.470.2788
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 1 Entered S L at
Length of Ser
Record Number
n ; , •
Time /./ / • ----/ ---/ - o pm
inspector Signature
Obstruction
Unable to„ push past
„ - feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
' 272
i !
—7077-9 _-_,, 2 ,.__
Poor PipeJoints - 7 , .-::- L.'
.
'-' ._.- --1 I
Mineral Deposits 4 ,,,,„4,./ , :7--,,,,5=„.-..., ---,)- Asp) i 7 „, /fy .--,. ) ,
, . ..„---...., ,..,..-) ...-- (
Sag/Pipe Deflection _11//771/2 _L/c / ,-•"' i • 7 /
4
Damaged Pipe
Transition
Final Cleanout:
•
--- - 1 ..,-.r. -....,- ; , / ...
1
Yellow Copy: City of Fagan-l-e 2: .- - ,„„ , ,,, , -C1.____„ ? i,
p .i.
.;;L_., „...,......7::,..,: ( a . " -- ":3 • ‘.2
,r,
Number
Correctly
Discharged
Incorrectly Unknown
Notes
..
(„/K ,c ,A ., . - -, ,----,
,-) ,t (7 , ) ,......":..,.- :.
.- _ / ,_.: ...4 .,<.? - -T
-„. - ;--..
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-
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,,(.---•,, e
• -., . ---,
7 L .- _ - ". i, ' --;,..--
--, / /3. _,--, ,...,11 ^ i .-c.' 1 i .-2 •-, 1
Sump pumps
Foundation drains
Total
MI
all
.` •
V
Roof drains
, /1/
411111111* C itpti v o
Residential Sanitary Sewer Service
Compliance Inspection
Date
, /?
/
Name -
House Number
Alternative Mailing Address
i - • •
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
Service Lateral inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Owner
.1 • • )4 am
Time Le • /0 pm
Disk #
MD Number
OwnerlOccupant Signature
. Street Name
/
Phone (.<:' L 7) —
/
For information call 651.470.2788
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 1 Entered S L at
Length of Ser
Record Number
n ; , •
Time /./ / • ----/ ---/ - o pm
inspector Signature
Obstruction
Unable to„ push past
„ - feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
' 272
i !
—7077-9 _-_,, 2 ,.__
Poor PipeJoints - 7 , .-::- L.'
.
'-' ._.- --1 I
Mineral Deposits 4 ,,,,„4,./ , :7--,,,,5=„.-..., ---,)- Asp) i 7 „, /fy .--,. ) ,
, . ..„---...., ,..,..-) ...-- (
Sag/Pipe Deflection _11//771/2 _L/c / ,-•"' i • 7 /
4
Damaged Pipe
Transition
Final Cleanout:
•
--- - 1 ..,-.r. -....,- ; , / ...
1
Yellow Copy: City of Fagan-l-e 2: .- - ,„„ , ,,, , -C1.____„ ? i,
p .i.
.;;L_., „...,......7::,..,: ( a . " -- ":3 • ‘.2
,r,
1 111 : 11. City of Cavan
Residential Sanitary Sewer Service
Compliance Inspection
Date . 1 I , / ;
Alternative Mailing Address
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.. &, • J
Name - ! -' - :1, f ✓J _` ° .,� Disk #
PID Number
House Number ! s Street Name
OwnerIOccupant Signature
o am
pm
For information call 651.470.2788
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 Entered S L. at
Roots
Poor Pipe Joints_
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number i
Time
O am
•
• o pm
Phone t 7 �
Inspector Signature
Obstruction
Unable to push past
feet.
Final Cleanout:
No Access
O No one in
I CR Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes �, �-
`:'
_ ", �! ;`
-
}
I
`r2' . !
Total
Sump pumps
1
Foundation drains
Roof drains
111
1 111 : 11. City of Cavan
Residential Sanitary Sewer Service
Compliance Inspection
Date . 1 I , / ;
Alternative Mailing Address
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.. &, • J
Name - ! -' - :1, f ✓J _` ° .,� Disk #
PID Number
House Number ! s Street Name
OwnerIOccupant Signature
o am
pm
For information call 651.470.2788
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 Entered S L. at
Roots
Poor Pipe Joints_
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number i
Time
O am
•
• o pm
Phone t 7 �
Inspector Signature
Obstruction
Unable to push past
feet.
Final Cleanout:
No Access
O No one in
I CR Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH