4747 Beacon Hill Rd - Inspection Form410
City of ;a aii
Residential Sanitary Sewer Service
Compliance Inspection
Date
,• � '
1 if
Name - ? f..v ' � � ? Disk #
PID Number
1 '
House Number Street Name
��-`- .``
Alternative Mailing Address
re
Compliance
O No foundation drain connection
Q No roof drain connection
d Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6 "Transition:
White Copy: Property Owner
6 am
a
Time • k, pm
Owner /Occupant Signature
-m-
Phone ,
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
serer
O Flexible sump pump piping
Record Number
Notes
Time
Obstruction
Unable to push past
feet
Number of stacks Entered S.L.at
Poor Pipe Joints
, 3
,f
r
0 am
•
• O pm
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
4
f
y
. '
'
t
/ f�
1 , -•?
L � .
'' 1 f r.
I ,
Foundation drains
Roof drains
w " - I
410
City of ;a aii
Residential Sanitary Sewer Service
Compliance Inspection
Date
,• � '
1 if
Name - ? f..v ' � � ? Disk #
PID Number
1 '
House Number Street Name
��-`- .``
Alternative Mailing Address
re
Compliance
O No foundation drain connection
Q No roof drain connection
d Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6 "Transition:
White Copy: Property Owner
6 am
a
Time • k, pm
Owner /Occupant Signature
-m-
Phone ,
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
serer
O Flexible sump pump piping
Record Number
Notes
Time
Obstruction
Unable to push past
feet
Number of stacks Entered S.L.at
Poor Pipe Joints
, 3
,f
r
0 am
•
• O pm
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH