4766 Beacon Hill Rd - Inspection Form4 1 ! 11°. City of Eapi
Residential Sanitary Sewer Service
Compliance Inspection
Date ) r '__
Name
I
PID Number
House Number Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection 0
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
/ ® No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Proper ty Owner
/ , #
am
Pm
Time • Pm
Owner /Occupant Signature
O
Flexible sump pump piping
Number of stacks
J
Non - Compliance
Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Length of Service:
Yellow Copy: City of Eagan
r.
Record Number
Phone
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
i
• Q am
• O pm
p siJ iv/ <d/f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH
Total
Notes
, !
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
,_-::"";_,
� ....
" 3 " f ,
Foundation drains
Roof drains
G , ,
2
4 1 ! 11°. City of Eapi
Residential Sanitary Sewer Service
Compliance Inspection
Date ) r '__
Name
I
PID Number
House Number Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection 0
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
/ ® No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Proper ty Owner
/ , #
am
Pm
Time • Pm
Owner /Occupant Signature
O
Flexible sump pump piping
Number of stacks
J
Non - Compliance
Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Length of Service:
Yellow Copy: City of Eagan
r.
Record Number
Phone
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
i
• Q am
• O pm
p siJ iv/ <d/f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH