4736 Beacon Hill Rd - Inspection FormResidential Sanitary Sewer Service
4 City of Cap Compliance Inspection
Date' ,;/
..)
Name I"°� i � i�'Disk #
PID Number
House Number -/"." . " ) /''; .)Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
4 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
\d No sump pump
4" to 6 "Transition:
White Copy: Pi operry Owner
• 0
Time • pm
OwnerlOccupant ignature
Length of Service:
Yellow Copy: City of Fagan
z
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
Record Number
Phone >
Time
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• o pm
For information call 651.470.2788
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
Pink Copy: SFH
Total
Notes
(% ) . 1
l
Number
Discharged
Correctly
Unknown
Sump pumps
�' e-"-.
f lncorrectly
lea; " :
` "'�
Foundation drains
Roof drains
• /
J
1
l ip f --- - •
Residential Sanitary Sewer Service
4 City of Cap Compliance Inspection
Date' ,;/
..)
Name I"°� i � i�'Disk #
PID Number
House Number -/"." . " ) /''; .)Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
4 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
\d No sump pump
4" to 6 "Transition:
White Copy: Pi operry Owner
• 0
Time • pm
OwnerlOccupant ignature
Length of Service:
Yellow Copy: City of Fagan
z
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
Record Number
Phone >
Time
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• o pm
For information call 651.470.2788
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
Pink Copy: SFH