4769 Beacon Hill Rd - Inspection FormCity or tapaa
Residential Sanitary Sewer Service
Compliance Inspection
Date i(' 3 /-) I /( ,/
Name 11 ,'7
PJD Number
House Number.
Alternative MailingAddress
Own er /Cicpant Signature
Compliance
O E No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
am
Time • Pm
Disk #ECI —L —LLI
/Y /Street Name _
Phone ! f
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
-- -.
Record Number T
Time
p am
•
• 0 P
Inspector Signature
For information call 65 1.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH
Notes
' _
- t- :�
�.
� .
_
� '
Nu
Correctly
Discharged
incorrectly
Unknown
Total
Sump pumps
/`
C� 1
i r
:,
Foundation drains
"'
Roof drains
1
City or tapaa
Residential Sanitary Sewer Service
Compliance Inspection
Date i(' 3 /-) I /( ,/
Name 11 ,'7
PJD Number
House Number.
Alternative MailingAddress
Own er /Cicpant Signature
Compliance
O E No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
am
Time • Pm
Disk #ECI —L —LLI
/Y /Street Name _
Phone ! f
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
-- -.
Record Number T
Time
p am
•
• 0 P
Inspector Signature
For information call 65 1.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout:
Pink Copy: SEH