4053 Beryl Rd - Inspection FormCity of hp
Residential Sanitary Sewer Service
Cornphiance Inspection
Date l/? 1 71)'
Name '
PID Number
House Number _) Street Name
Alternative MailingAddress
l
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
y7 No roof drain connection
6 Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Late al Inspection Findings Number o'stacks
I "-
Roots ! •.� f -7
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
4" to 6" Transition:
White Copy: Property Owner
Time
#
am
pm
;
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
Damaged Pipe
Transition rq f� = -- r :t
Yellow Copy: City of Eagan
Record Number
Ti me
Obstruction
Unable to push past
feet
Phone i> ) " fir,
Inspector Signature
O Inspection
refused
J
Entered S L at = '
No Access
O No one in
O Access to service
lateral needed
Length of Service: �� 1 Final Cleanout:
Pink Copy: SEH
Total
Notes
...•
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
'1�
Foundation drains
�'
�'
Roof drains
cY
City of hp
Residential Sanitary Sewer Service
Cornphiance Inspection
Date l/? 1 71)'
Name '
PID Number
House Number _) Street Name
Alternative MailingAddress
l
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
y7 No roof drain connection
6 Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Late al Inspection Findings Number o'stacks
I "-
Roots ! •.� f -7
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
4" to 6" Transition:
White Copy: Property Owner
Time
#
am
pm
;
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
Damaged Pipe
Transition rq f� = -- r :t
Yellow Copy: City of Eagan
Record Number
Ti me
Obstruction
Unable to push past
feet
Phone i> ) " fir,
Inspector Signature
O Inspection
refused
J
Entered S L at = '
No Access
O No one in
O Access to service
lateral needed
Length of Service: �� 1 Final Cleanout:
Pink Copy: SEH