4632 Beacon Hill Rd - Inspection FormSump pumps
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Foundation drains
Roof drains
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Cita of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date :/ . V 1 it
Name
Alternative Mailing Address
4" to 6" Transition:
PID Number
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
Time •
d pm
. .= ,f?isk #
House Number Street Name
Owner /Occupant Signature
m
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Surnp pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: Final Cleanout:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number f `°
r
Notes
Time
Phone('
Obstruction
Unable to push past
feet
• O am
• o pm
. f
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH