4650 Beacon Hill Rd - Inspection Form11 City of Capp
Residential Sanitary Sewer Service
Compliance Inspection
3 ) 1r
Date
Name 11
PID Number
House Number - ° Z- Street Name
Alternative Mailing Address
Foundation drains
Roof drains
Total
Correctly
Number Discharged
Incorrectly
Unknown
Sump pumps
White Copy: Property Owner
Time 0
Disk #t
OwnerlOccupant St ignature
Record Number
-m -m
Yellow Copy: City of Eagan
O am
Time : O pm
Phone f< l w
Notes
M.
Inspector Signature
For information call 6 51.470.2788
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
Non - Compliance
0 Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks Entered S L,at
Obstruction
Unable to push past
feet
No Access
No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
4 11 City f E re
Y � a
Residential Sanitary Sewer Service
Compliance Inspection
Date _ t 2 1)( •'
Name,' }'�^, �!
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
4" to 6 "Transition:
� O 2 .
�' % am
Time s T� k( pm
Disk # 1 —
PID Number
House Number ' ",...._.. Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
Non - Compliance
0
O
O
O
O
L
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
White Copy: Property Owner
Record Number °
J
Entered S L at
Notes
Phone
Time
l
. f
Inspector " Signature
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
• O pm
'2 of ,,r
No Access
Noonei
7 Access -t+ c ' e / i ce
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
Foundation drains
---
---
Roof drains
4 11 City f E re
Y � a
Residential Sanitary Sewer Service
Compliance Inspection
Date _ t 2 1)( •'
Name,' }'�^, �!
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
4" to 6 "Transition:
� O 2 .
�' % am
Time s T� k( pm
Disk # 1 —
PID Number
House Number ' ",...._.. Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
Non - Compliance
0
O
O
O
O
L
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
White Copy: Property Owner
Record Number °
J
Entered S L at
Notes
Phone
Time
l
. f
Inspector " Signature
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
• O pm
'2 of ,,r
No Access
Noonei
7 Access -t+ c ' e / i ce
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Sump pumps
�
Foundation drains
-
Roof drains
L....4
-/
City off Ea pi
Residential Sanitary Sewer Service
Compliance Inspection
Date it / h'
Name (
- t'r' ( Disk #
PID Number
House Number f "t':2 —__ L- Street Name
Alternative Mailing Address Phone
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
48___? am
Time _ , • pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
.PINE
Record Number
2
) , )
ri • 0 am
Time • p pm
Obstruction
Unable to push past
feet
r
Inspector Signature _A f f �
f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L. at
Roots
Poor. Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
White Copy: Property Owner
Yellow Copy: City of Eagan
Notes
Final Cleanout:
„
G1 1
IT J I
Pink Copy: SEH
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