4780 Beacon Hill Rd - Inspection FormSump pumps
/1
/
Foundation drains
Roof drains
/L_
Cit al' hp
Residential Sanitary Sewer Service
Compliance Inspection
Date /( �
Name /}� �� 7 Disk # 1_ _
PID Number
House Number w i Street Name
Alternative Mailing Address
1
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
} i • 5C o am
Time • rpm
i
Owner /Occupant Signature
Non - Compliance
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - --...-- I1 .% - _ _/ �_ = - - s.,:7"t 3/ ,i., /-
/
7
1
Lengt1 of Service:
Number Discharged
Total 1 Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number i
Entered SL at
Notes
3
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
O am
•
• Opm
r „7„
Phone
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH