4774 Beacon Hill Rd - Inspection FormCity of 1,a a
Residlentiai Sanitary Sewer Service
Compliance Inspection
Date l,Y ._I 7 / /s _ Time a._ - pm
Name
PID Number
House Number Street Name
Alternate +e MailingAddress , ..
I
OwnerlOccupant Signature
r Li-Di
/e—
Record Number
Time
Inspector Signature
0 am
•
• O pm
_ A
�l ) I i c
Phone / __`7.� r✓ a-J./
For information cal
65
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
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:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered S..L at
Notes
� � d
Final Cleanout:
No Access
O No one in
Y
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number.
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
.
.. `,".1
1" <2
i _
J
2
) _ . ,
s �
^ 1 ..
Foundation drains
Roof drains
City of 1,a a
Residlentiai Sanitary Sewer Service
Compliance Inspection
Date l,Y ._I 7 / /s _ Time a._ - pm
Name
PID Number
House Number Street Name
Alternate +e MailingAddress , ..
I
OwnerlOccupant Signature
r Li-Di
/e—
Record Number
Time
Inspector Signature
0 am
•
• O pm
_ A
�l ) I i c
Phone / __`7.� r✓ a-J./
For information cal
65
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
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:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered S..L at
Notes
� � d
Final Cleanout:
No Access
O No one in
Y
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH