4711 Beacon Hill Rd - Inspection FormHouse Number
// /mil f' l
fd No sump pump
4" to b "Transition:
City of Fiapo
Residential Sanitary Sewer Service
Compliance Inspection
i _
Date /.�1 x' .111
Time
am
Pm
Name ` ` i, . .• e ' i , r.°/ Disk ## r • ,,
>
PID Number
Compliance
O No foundation drain connection
No roof drain connection
/J Sump pit not connected to
sanitary sewer
R
Sump pump properly piped
White Copy: Proper Owner
{ / / /
/ OwnerlOccupant Signature
Length of Service:
I Street Name
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
Yellow Copy: City of Eagan
Record Number
Time
. a
Alternative Mailing Address Phone /
Entered S.L. at
Iwo
Obstruction
Unable to push past
feet
Final Cleanout:
q am
O pm
r ()
Inspector Signature
For information call 651.470.2788
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 Discharged
Notes
c '. ° ! f 2 V t ;:.
i r ° = ,r > : f
_ �i_ ` ' i � ' = " �i
Total Correctly Incorrectly Unknown
Sump pumps
MEM=
Foundation drains
Roof drains
House Number
// /mil f' l
fd No sump pump
4" to b "Transition:
City of Fiapo
Residential Sanitary Sewer Service
Compliance Inspection
i _
Date /.�1 x' .111
Time
am
Pm
Name ` ` i, . .• e ' i , r.°/ Disk ## r • ,,
>
PID Number
Compliance
O No foundation drain connection
No roof drain connection
/J Sump pit not connected to
sanitary sewer
R
Sump pump properly piped
White Copy: Proper Owner
{ / / /
/ OwnerlOccupant Signature
Length of Service:
I Street Name
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
Yellow Copy: City of Eagan
Record Number
Time
. a
Alternative Mailing Address Phone /
Entered S.L. at
Iwo
Obstruction
Unable to push past
feet
Final Cleanout:
q am
O pm
r ()
Inspector Signature
For information call 651.470.2788
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