4727 Beacon Hill Rd - Inspection FormCity 1' ha a�
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date /./'');/
Ji✓ ,
Name
House Number
L.
Compliance
O No foundation drain connection
No roof drain connection
Sump pic not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4” to 6" Transition:
White Copy: Property Owne ;
Time / •
Disk #
PID Number
...7..—....- 'Street Name
Alternative Mailing Address
Owner /Occupant Signature
Service Lateral Inspection Findings
0: am
lT pm
-CO
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
Length of Service:
Yellow Copy: City of Eagan
Record Number.
I I Time
Phone ) '
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
o am
O pm
Inspector Signature )) 1 .//7
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Entered S L.at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
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Total
Sump pumps
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Foundation drains
Roof drains
City 1' ha a�
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date /./'');/
Ji✓ ,
Name
House Number
L.
Compliance
O No foundation drain connection
No roof drain connection
Sump pic not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4” to 6" Transition:
White Copy: Property Owne ;
Time / •
Disk #
PID Number
...7..—....- 'Street Name
Alternative Mailing Address
Owner /Occupant Signature
Service Lateral Inspection Findings
0: am
lT pm
-CO
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
Length of Service:
Yellow Copy: City of Eagan
Record Number.
I I Time
Phone ) '
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
o am
O pm
Inspector Signature )) 1 .//7
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Entered S L.at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH