4626 Beacon Hill Rd - Inspection FormCity ill Ea ui
Residential Sanitary Sewer Service
Compliance Inspection
! 2 /
Date if /1 .j / e i
' ri-i Name Disk
m
�" �''��i';- ''��
PID Number
House Number
Cl! Street Name
Alternative Mailing Address
l ,
No roof drain connection
Ownerlekcupant Signature
Compliance
O No foundation drain connection
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
Time • I k T S pm
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
Yellow Copy: City of Eagan
Record Number
Number of stacks Entered SL, at
•
Time • o pm
I -7
Phone 2
0 am
Obstruction
Unable to push past
feet
Inspector Signature ) \ �2! ✓ L
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
•
/
' y 7J r� ; �`
f x
/Length of Service: Final Cleanout:
Pink Copy: SEH
Total
4�
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
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Foundation drains
Roof drains
City ill Ea ui
Residential Sanitary Sewer Service
Compliance Inspection
! 2 /
Date if /1 .j / e i
' ri-i Name Disk
m
�" �''��i';- ''��
PID Number
House Number
Cl! Street Name
Alternative Mailing Address
l ,
No roof drain connection
Ownerlekcupant Signature
Compliance
O No foundation drain connection
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
Time • I k T S pm
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
Yellow Copy: City of Eagan
Record Number
Number of stacks Entered SL, at
•
Time • o pm
I -7
Phone 2
0 am
Obstruction
Unable to push past
feet
Inspector Signature ) \ �2! ✓ L
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
•
/
' y 7J r� ; �`
f x
/Length of Service: Final Cleanout:
Pink Copy: SEH