4795 Beacon Hill Rd - Inspection FormCity of Up
Residential Sanitary Sewer Service
Compliance Inspection
/��•.�
Time • '041 pm am
/ j �
Name ) A .4 ,/ 7° im ? Disk #L1 —
PID Number
House Number �_Street Name
•
(7 t /)
Date /i /I ! / i
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
"
Transition
4 to 6" Transition:
White Copy: Property Owner
Length of Service:
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
Yellow Copy: City of Eagan
I
Record Number
Time
Obstruction
Unable to push past
feet
1 -4
Final Cleanout:
• O am
• O pm
Phone 1—
„ �
Inspector Signature
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
2..,,...„,,,-,.„....„,/,,,-.4 r
1 ....
Pink Copy: SEH
Notes
J -
1.
i
. :
Number
Correctly
Discharged
Incorrectly
Unknowns
Total
Sump pumps
_
1 �:
{
Foundation drains
Roof drains
--
City of Up
Residential Sanitary Sewer Service
Compliance Inspection
/��•.�
Time • '041 pm am
/ j �
Name ) A .4 ,/ 7° im ? Disk #L1 —
PID Number
House Number �_Street Name
•
(7 t /)
Date /i /I ! / i
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
"
Transition
4 to 6" Transition:
White Copy: Property Owner
Length of Service:
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
Yellow Copy: City of Eagan
I
Record Number
Time
Obstruction
Unable to push past
feet
1 -4
Final Cleanout:
• O am
• O pm
Phone 1—
„ �
Inspector Signature
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
2..,,...„,,,-,.„....„,/,,,-.4 r
1 ....
Pink Copy: SEH