4783 Beacon Hill Rd - Inspection FormCity �i' eta n
Y p
Residential Sanitary Sewer Service
Compliance Inspection
r f
Date j/ 1;" 1 !(
'?
Name d � ,��✓.�'._ -c ,- ,'Disk #
PID Number
House Number 2--)-
Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance Non- Compliance
O No foundation drain connection 0 Clear water connections to
0 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 (honer
Time
OwnerlOccupant Signature
• am
• pm
1- CD -LI_J
Record Number
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
r 11 ,sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered 5 L at
Time
o am
•
• o pm
i
in spector Signature 1\) )
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes _
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Number
Discharged
Correctly
Incorrectly
Unknown
S ump pumps
v
Foundation drains
Roof drains
i
City �i' eta n
Y p
Residential Sanitary Sewer Service
Compliance Inspection
r f
Date j/ 1;" 1 !(
'?
Name d � ,��✓.�'._ -c ,- ,'Disk #
PID Number
House Number 2--)-
Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance Non- Compliance
O No foundation drain connection 0 Clear water connections to
0 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 (honer
Time
OwnerlOccupant Signature
• am
• pm
1- CD -LI_J
Record Number
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
r 11 ,sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Entered 5 L at
Time
o am
•
• o pm
i
in spector Signature 1\) )
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH