4676 Beacon Hill Rd - Inspection FormSump pumps
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Foundation drains
Roof drains
4111 City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
I /1 d — )7/).
Date l 1 r�
Name
PID Number
House Number i r 1 Street Name
Alternative Mailing Address
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J y ( 1 �
I� Owner(Occupont Signature
For information call 651.470.2788
Compliance
0 No foundation drain connection
)
0 No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
° Disk #
am
Time _ m.:� • pm
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
Total Correctly
1-
Number of stacks
Length of Service:
Number Discharged
Incorrectly Unknown
Yellow Copy: City of Eagan
f
Record Number
Notes
Time
Phone
•
•
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S L,at
Final Cleanout:
o am
o pm
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH