4070 Beryl Rd - Inspection FormtV PI)
i/f
Residential Sanitary Sewer Service
City of Eamo Compliance Inspection
Date l✓c< / / /'
_
Name 6 efr-
PID Number
House Number /4) Street Name
Alternative MailingAddress
Owner /Occupant Signature
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition: -
White Copy: Proper ty Owner
Time ,� OCi
1
Disk #
o,am
Number of stacks
221411 D
one 2 «r "
For information ,call 6511
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
f
.7 lam
Time / -o pm
7 Inspector Signature
Obstruction
Unable to push past
6 °Xfeet
Entered S L at -
Final Cleanout: I"
Notes ) I
�^ I
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
___________
. __ - -..w
Roof drains
tV PI)
i/f
Residential Sanitary Sewer Service
City of Eamo Compliance Inspection
Date l✓c< / / /'
_
Name 6 efr-
PID Number
House Number /4) Street Name
Alternative MailingAddress
Owner /Occupant Signature
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition: -
White Copy: Proper ty Owner
Time ,� OCi
1
Disk #
o,am
Number of stacks
221411 D
one 2 «r "
For information ,call 6511
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
f
.7 lam
Time / -o pm
7 Inspector Signature
Obstruction
Unable to push past
6 °Xfeet
Entered S L at -
Final Cleanout: I"
Notes ) I
�^ I
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH