4744 Beacon Hill Rd - Inspection FormSump pumps -
7 S
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It of Eapo
Residential Sanitary Sewer Service
Compliance Inspection
House Number
)(,
Date R i
Name k
PID Number
Alternative Mailing Address
Owner/Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not conneted
sanitary sewer q
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
Disk #
(-7 am
Titrzo /0 p
- 1 - Street Name
Service Lateral Inspection Findings
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
Roots
Poor. Pipejoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
White Copy: Pi opel ty Owner
Number of stacks Entered S L.at
\.)
Total
Length of Service:
Number Discharged
Correctly Incorrectly Unknown
LL
Record Number —
Notes
Time
•
0 am
0 pm
Phone r(. ) ; (1 ?
Obstruction
Unable to push past
feet
inspector Signature
Final Cleanout:
No Access
O No one in
O Inspection
refused
O Access to service
lateral needed
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Yellow Copy: City of Eagan
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