4681 Beacon Hill Rd - Inspection FormC 01 '
Residential Sanitary Sewer Service
Compliance Inspection
Date)! //
Name 1 �_
PID Number
House Number
Alternative MailingAddress
Owner /Occupant Signature
For information call 65 1:470:2788
Compliance
O No foundation drain connection
, X 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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
,
i
Time 1
Disk#
1
Street Name
9 am
• / pm
1- LL-LL
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
/' sewer
Flexible sump pump piping
Number of stacks
Length of Sefvice:
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
•
Time •
ins ctor Signature
Obstruction
Unable to push past
feet
Entered S.L at
Final Cleanout:
o am
o pm
No Access
O No one in
O Inspection
refused
O Access to service
lateral needed
Pink Copy: SEH
Number
Correct) Y
Discharged--
Incorrect) Unknown
Y
Notes
j
L
� f ' '� i ,
1!- fl
' t _,
Total
Sump pumps
Foundation drains
Roof drains
- . -
/
C 01 '
Residential Sanitary Sewer Service
Compliance Inspection
Date)! //
Name 1 �_
PID Number
House Number
Alternative MailingAddress
Owner /Occupant Signature
For information call 65 1:470:2788
Compliance
O No foundation drain connection
, X 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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
,
i
Time 1
Disk#
1
Street Name
9 am
• / pm
1- LL-LL
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
/' sewer
Flexible sump pump piping
Number of stacks
Length of Sefvice:
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
•
Time •
ins ctor Signature
Obstruction
Unable to push past
feet
Entered S.L at
Final Cleanout:
o am
o pm
No Access
O No one in
O Inspection
refused
O Access to service
lateral needed
Pink Copy: SEH