4629 Beacon Hill Rd - Inspection Formud0 ftg
4 1 . 1 ) 11k City f Fa a
Y o s
Residential Sanitary Sewer Service
Compliance Inspection
Date / / Time
` am
• 0 P
Record Number
Name. o ) a .!1✓ l
_ ) /)<' Disk # 1
PID Number }
House Number : 0. Street Name -,
1 i
Phone L---)) 7 . .2- -
Alternative Mailing Address
4" to 6" Transition:
White Copy: Proper ty Owner
Owner/Occupant Signature
Compliance
` O No foundation drain connection
�� /
1 ' No roof drain connection
° °° Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
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
Length of Service:
Yellow Copy: City of Eagan
0 am
•
Time • _ p pm
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
4_ . "
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
`>) ,r i
/7) mot}
Foundation drains
i
Roof drains
ud0 ftg
4 1 . 1 ) 11k City f Fa a
Y o s
Residential Sanitary Sewer Service
Compliance Inspection
Date / / Time
` am
• 0 P
Record Number
Name. o ) a .!1✓ l
_ ) /)<' Disk # 1
PID Number }
House Number : 0. Street Name -,
1 i
Phone L---)) 7 . .2- -
Alternative Mailing Address
4" to 6" Transition:
White Copy: Proper ty Owner
Owner/Occupant Signature
Compliance
` O No foundation drain connection
�� /
1 ' No roof drain connection
° °° Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
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
Length of Service:
Yellow Copy: City of Eagan
0 am
•
Time • _ p pm
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
4_ . "
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH