4775 Beacon Hill Rd - Inspection Form41111. City of Cap
Residential Sanitary Sewer Service
Compliance Inspection
Date if ,1 / �- 1 f ,f
Name _ . 1
•
Time •
Disk #
PID Number
House Number L -- / /----)Street Name
y .a�
Owner /Occupant Signature
a
Pm
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
01 No roof drain connection
is
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
f4
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O Clear water connections to
sanitary sew „e`
O Serviceleral defects
O Defective manholes
O Sump pump connected to sanitar•yi
sewer
O Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number r'
A //
Time
Obstruction
Unable to push past
feet
•
1 1
o
Phone f - ,
Inspe Signature
Final Cleanout:
o am
o pm
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
Total
Sump pumps
j
Foundation drains
MUM
F
Roof drains
41111. City of Cap
Residential Sanitary Sewer Service
Compliance Inspection
Date if ,1 / �- 1 f ,f
Name _ . 1
•
Time •
Disk #
PID Number
House Number L -- / /----)Street Name
y .a�
Owner /Occupant Signature
a
Pm
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
01 No roof drain connection
is
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
f4
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O Clear water connections to
sanitary sew „e`
O Serviceleral defects
O Defective manholes
O Sump pump connected to sanitar•yi
sewer
O Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number r'
A //
Time
Obstruction
Unable to push past
feet
•
1 1
o
Phone f - ,
Inspe Signature
Final Cleanout:
o am
o pm
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH