4621 Beacon Hill Rd - Inspection FormCity of Ego
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 1 ,�'
Name
House Number
PID Number
Alternative Mailing. Address Phone
i F F
/ /
6 '' r Owner/Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected co
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
White Copy: Property Owner
• am
Time • pm
Disk #
Street Name
L
. r f 1
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
Record Number
Time
Obstruction
Unable to push past
feet
Final Cleanout:
• o am
• 0Pm
Inspector Signature 2
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
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1
Total
Sump pumps
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Foundation drains
Roof drains
City of Ego
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 1 ,�'
Name
House Number
PID Number
Alternative Mailing. Address Phone
i F F
/ /
6 '' r Owner/Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected co
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
White Copy: Property Owner
• am
Time • pm
Disk #
Street Name
L
. r f 1
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
Record Number
Time
Obstruction
Unable to push past
feet
Final Cleanout:
• o am
• 0Pm
Inspector Signature 2
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH