4687 Beacon Hill Rd - Inspection Form4. 1 _ 11. City uF Ea an
Y �
Residential Sanitary Sewer Service
Compliance Inspection
, , �...J
Date � (._''� I �
� w I
Name( )0 ) ('')l - 4 tr Disk # l
PID Number
House Number w~��/' Street Name
Alternative Mailing Address
For information call 651.470.2788
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: Proper Owner
} •Z-� am
Time 1 • o p
73
dwner /Occupant Signature
m -rm ❑
Length of Service:
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 Entered S at
Yellow Copy: City of Eagan
Record Number
Time
. %� i�
Phone C.7.--)
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
O am
• O Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
'? 1
) ='i �i1
,' 2
r a - -
>>. 1
.''
ay
:�(:
its
�
1
Number
Correctly
Discharged
Incorrectly
Unknown
Total
pumps Sum
PP p
, :
a� - - _
(
7 ,r:
Foundation drains
Roof drains
4
4. 1 _ 11. City uF Ea an
Y �
Residential Sanitary Sewer Service
Compliance Inspection
, , �...J
Date � (._''� I �
� w I
Name( )0 ) ('')l - 4 tr Disk # l
PID Number
House Number w~��/' Street Name
Alternative Mailing Address
For information call 651.470.2788
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: Proper Owner
} •Z-� am
Time 1 • o p
73
dwner /Occupant Signature
m -rm ❑
Length of Service:
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 Entered S at
Yellow Copy: City of Eagan
Record Number
Time
. %� i�
Phone C.7.--)
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
O am
• O Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH