4628 Beacon Hill Rd - Inspection FormSump pumps
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Foundation drains
Roof drains
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City of Capri
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Residential Sanitary Sewer Service
Compliance Inspection
Date j 1 �?
Name
House Number i
r
4" to 6" Transition:
White Copy: Proper ty Owner
isk
Compliance
No foundation drain connection
No roof drain connection
9 Sump pit not connected to
. sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
j,•C`...C_i /am
Time • e Qi pm
PIE) Number
Street Name
Owner /Occupant Signature
Alternative Mailing Address
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:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Phone %; -_'> 1
Notes
Time
r 9.
A/2
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• p am
• O pm
For information call 651.470.2788
No Access
O No one in
Entered S L at
Roots
Poor Pipe]oints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
/j
2, T
O Access to service
lateral needed
O Inspection
refused
•
Pink Copy: SE H