4658 Beacon Hill Rd - Inspection FormSump pumps
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Foundation drains
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Roof drains
City of Cap
Residential Sanitary Sewer Service
Compliance Inspection
/2 /' 7 )
Date / 1/ , / f Time
Name .„„ /1 V Disk #
PlD Number
House Number
Alternative Mailing Address
A
4" to 6" Transition:
White Copy: Property Owner
Street Name
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Owner /Occupant Signature "]>
Service Lateral Inspection Findings
Total
am
• • /0 pm
LLJ
For information call 651 .470.2788
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
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Number Discharged
Correctly incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Time
l
f1
- " 2- 1,11 1-4 T
Phone ! ° —
inspector Signature
Obstruction
Unable to push past
feet
Notes
•
•
Entered S.L.at
Final Cleanout:
0 a
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEI-3