4630 Beacon Hill Rd - Inspection Form4 11. City of Ea afl
Residential Sanitary Sewer Service
Compliance Inspection
r
Date Al ▪ d l
T T
Name
PID Number
House Number
7}
f P
Compliance
O No foundation drain connection
No roof 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
Time
Disk #
` /Street Name
,/ :dwnerlOccupant Signature
Service Lateral Inspection Findings
am
• 'O pm
-LE
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
m
Record Number
Time
•
•
Alternative Mailing Address Phone ( -.2 )
Obstruction
Unable to push past
feet ..
o am
O pm
Inspector Signature
Final Cleanout:
For information call 651.470.2788
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
Total
Sump pumps
.17 �
a /
s/ i t d
j ,' -, f f
�� ti m
f) tom. r : ,,,
Foundation drains
--
�
Roof drains
` fi
4 11. City of Ea afl
Residential Sanitary Sewer Service
Compliance Inspection
r
Date Al ▪ d l
T T
Name
PID Number
House Number
7}
f P
Compliance
O No foundation drain connection
No roof 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
Time
Disk #
` /Street Name
,/ :dwnerlOccupant Signature
Service Lateral Inspection Findings
am
• 'O pm
-LE
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
m
Record Number
Time
•
•
Alternative Mailing Address Phone ( -.2 )
Obstruction
Unable to push past
feet ..
o am
O pm
Inspector Signature
Final Cleanout:
For information call 651.470.2788
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