4664 Beacon Hill Rd - Inspection Form46 ' cat of ka an
Residential Sanitary Sewer Service
Compliance Inspection
Date WI .1 II
w
Name %() " {A' Disk#
PID Number
House Number o� Street Name
Get , aJ
O'rnerl0ccupant 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
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits.
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
J am
Time • q pm
-m -w
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
i
,�-- -y
/ 'Length of Servic :
Record Number
Time
•
•
o am
o pm
Alternative Mailing Address Phone
� Inspector Signature }
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L. at
Notes
Final Cleanout:
L -P j
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r ;1/ f r (
rai
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
/
a
1
�y�
Foundation drains
Roof drains
46 ' cat of ka an
Residential Sanitary Sewer Service
Compliance Inspection
Date WI .1 II
w
Name %() " {A' Disk#
PID Number
House Number o� Street Name
Get , aJ
O'rnerl0ccupant 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
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits.
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
J am
Time • q pm
-m -w
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
i
,�-- -y
/ 'Length of Servic :
Record Number
Time
•
•
o am
o pm
Alternative Mailing Address Phone
� Inspector Signature }
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L. at
Notes
Final Cleanout:
L -P j
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r ;1/ f r (
rai
Yellow Copy: City of Eagan Pink Copy: SEH