4612 Penkwe Way - Inspection Form 1
Residential Sanitary Sewer Service
Efly of 1j Compliance Inspection
dates 1 ""I? Time pm Record Number
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Name t :f%y~~ %s Disc # Time a Rm
PID Number
House Number ~fi:' rl.e Street Name'
Alternative Mailing Address Phone
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OwnerlOccupont Signature Inspector Signature
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For. information call 65.1.470.2788
Compliance Non-Compliance Obstruction No Access
O No foundation drain connection O Clear water connections to Unable to push past O No one in
O No roof drain connection sanitary sewer, !feet O Access to service
O Service lateral defects lateral needed
O Sump pit not connected to O Defective manholes
sanitary sewer O Inspection
O Sump pump connected to sanitary refused
O Sump pump properly piped sewer
O No sump pump O Flexible sump pump piping
~EnteredSL,at
Service Lateral Inspection Findings Number of stacks
Roots
Paorl'ipeJoipis , c;
Mineral Qdposits
SaglPipd Deflection _ 1cf^ 'r / , r
Damaged Pipe /
Transition
,,r''!F ' Final Cleanout:
4" to 6"Transition: Length of Service:
Notes
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Total Correctly Incorrectly Unknown a 'j t J
Sump pumps
~C_ b t
Foundation drains9
Roof drains
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH