4779 Beacon Hill Rd - Inspection FormSump pumps
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Foundation drains
drains
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4 ,0 1 ' City of Ea i
Residential Sanitary Sewer Service
Compliance Inspection
Date , .j .1/ 1 l 1
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Compliance
O No foundation drain connection
c No roof drain connection
• Sump pit not connected to
/ sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Name i / f `J' /. ..2-H - 7 1 7 /Disk #
PID Number
House Number 21 .777 %Street Name
Alternative Mailing Address Phone
Owner /Occupant Signature
Service Lateral Inspection Findings
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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:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number. /
Notes
A
Time
inspector Signature
Final Cleanout:
• O am
• O pm
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For information call 65 1.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet O Access to service
lateral needed
0 Inspection
refused
Number of stacks Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
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Yellow Copy: City of Eagan Pink Copy: SEH