4750 Beacon Hill Rd - Inspection FormCity of Ea pi
i
Residential Sanitary Sewer Service
Compliance Inspection
Date ! • . 1/ ( I(` Time
Name I, /.. Disk #
PID Number
House Number =- °t - ? ( ,Street Name
Alternative Mailing Address
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
4" to 6 "Transition:
White Copy: Property Owner
!) Owner /Occupant Signature
am
pm
For information call 65
Non - Compliance
O
O
O
O
O
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
— 3 c
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks Entered S L. at
Length of Service:
Record Number ."/ ----
)
Notes
7!,
o am
•
Time • o pm
) ` '
Inspector Signature
obstruction
Unable to push past
feet
Final Cleanout:
f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
y f
Total
Number Discharged . .
Correctly
Incorrectly
Unknown
Sump pumps
. / -
�, , j "
( ,-
d
Foundation drains
Roof drains
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City of Ea pi
i
Residential Sanitary Sewer Service
Compliance Inspection
Date ! • . 1/ ( I(` Time
Name I, /.. Disk #
PID Number
House Number =- °t - ? ( ,Street Name
Alternative Mailing Address
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
4" to 6 "Transition:
White Copy: Property Owner
!) Owner /Occupant Signature
am
pm
For information call 65
Non - Compliance
O
O
O
O
O
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
— 3 c
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks Entered S L. at
Length of Service:
Record Number ."/ ----
)
Notes
7!,
o am
•
Time • o pm
) ` '
Inspector Signature
obstruction
Unable to push past
feet
Final Cleanout:
f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
y f