4640 Beacon Hill Rd - Inspection Form4 City of lia ii
Residential Sanitary Sewer Service
Compliance Inspection
Date I ;1, 7 /
Name �"°"t ! �
li
Alternative Mailing Address
r_
4" to 6 " Transition:
White Copy: Property Owner
• _ gam
Time ; • O pm
Disk #
PID Number
House Number Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
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
Length of Service:
Yellow Copy: City of Eagan
�r 1
Record Number ti
Phone
Time
Number of stacks Entered S.L. at
Obstruction
Unable to push past
feet
•
•
o am
O pm
- 1
Inspector Signature } - ?
For information call 651,470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused.
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Notes
1 .
•
w " '� ' r'
r
,---" -- /'a /47 '_ "i`7 c :.-- .
✓ `
Total
Incorrectly
Unknown
Sump pumps
?
y
Foundation drains
Roof drains
1
,f--- --i .--
4 City of lia ii
Residential Sanitary Sewer Service
Compliance Inspection
Date I ;1, 7 /
Name �"°"t ! �
li
Alternative Mailing Address
r_
4" to 6 " Transition:
White Copy: Property Owner
• _ gam
Time ; • O pm
Disk #
PID Number
House Number Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
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
Length of Service:
Yellow Copy: City of Eagan
�r 1
Record Number ti
Phone
Time
Number of stacks Entered S.L. at
Obstruction
Unable to push past
feet
•
•
o am
O pm
- 1
Inspector Signature } - ?
For information call 651,470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused.
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH