4637 Beacon Hil Rd - Inspection FormCity 1 Ea a
Y � u
Residential Sanitary Sewer Service
Compliance Inspection
Date ( (?
, /' 1 .
Name 2/1
PID Number
House Number () 3 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
4 1 No roof drain connection
Sump pit not connected to
\ sanitary sewer
011 ; Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
%��•. 'el am
Time • /6 pm
Disk #
'gwner /Occupant Signature
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
L� Time
i •�- /
7 i ! J Cdr
Phone () r • r ar'
tir
Inspector Signature
• Oam
• O pm
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
,ii
3 :,, ----, 3 F ,/)_
-r-
Total
Sump pumps
' a
i
Foundation drains
Roof drains
IMI
11.
City 1 Ea a
Y � u
Residential Sanitary Sewer Service
Compliance Inspection
Date ( (?
, /' 1 .
Name 2/1
PID Number
House Number () 3 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
4 1 No roof drain connection
Sump pit not connected to
\ sanitary sewer
011 ; Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
%��•. 'el am
Time • /6 pm
Disk #
'gwner /Occupant Signature
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
L� Time
i •�- /
7 i ! J Cdr
Phone () r • r ar'
tir
Inspector Signature
• Oam
• O pm
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH