4715 Beacon Hill Rd - Inspection Formr C y oI Lapp
Residential Sanitary Sewer Service
Compliance inspection
("
Date --
Name ' = - -- 111 Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O 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 Number of stacks
4" to 6" Transition:
White Copy: Pr operty Owner
•a
Time o pm
- J) Street Name i = r
Ow nerfOctupa t Signature
- r
1. "
Yellow Copy: City of Eagan
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
Record Number
Time .y ® O pm
Phone I s'� -� �'
inspector 5i gnature
For information call 65
Obstruction
Unable to push past
feet
c '
Entered SL.at
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition -- ) 11 /
.j .
Length of Service: - `"% L' -4 Final Cleanout
Pink Copy: SEH
Total
i
No ?es
7 -- 4 - ? ' ) ( i (, T ; 7 -• -.a .
- _,, : lF:-
-
Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
sr!
Foundation drains
Lam'
Roof drains
r C y oI Lapp
Residential Sanitary Sewer Service
Compliance inspection
("
Date --
Name ' = - -- 111 Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O 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 Number of stacks
4" to 6" Transition:
White Copy: Pr operty Owner
•a
Time o pm
- J) Street Name i = r
Ow nerfOctupa t Signature
- r
1. "
Yellow Copy: City of Eagan
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
Record Number
Time .y ® O pm
Phone I s'� -� �'
inspector 5i gnature
For information call 65
Obstruction
Unable to push past
feet
c '
Entered SL.at
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition -- ) 11 /
.j .
Length of Service: - `"% L' -4 Final Cleanout
Pink Copy: SEH