4624 Beacon Hill Rd - Inspection FormNotes
Number
Correctly
Discharged
Incorrectly
Unknown
J l], -- -7, J � �- d ')
` '
-
Total
Sump pumps
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a
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Foundation drains
Roof drains
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City of Evan
Residential Sanitary Sewer Service
Compliance Inspection
Time 4 •
?, (1).� i' Disk #
PID Number
Date
Name
1 -louse Number
Live Mailing Address Phone r 2
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
u u Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
.2 - Street Name
f,' a lt
•
Owner /Occupant signature
am
0 pm
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
Time
Record Number
O am
•
• p pm
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S. at
Pink Copy: SEH