4711 Penkwe Cir - Inspection Forms41011
Cit of Ea pp
Residential Sanitary Sewer Service
Compliance Inspection
Date / `_ • i /
Name
P1D Number
House Number
Alt native Mailing Add ress
4" to 6" Transition:
White Copy: Property Owner
.-. �_..
Time •
Disk #
! 1 ) Street Name
r � .
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
0
O
O
0
0
O Pm
Non - Compliance
-
Number of stacks
Length of Service:
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Phone
Time
I
i
O am
•
• ,_O pm
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
For information call 651.470.2788
Roots
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Entered S. L at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
,
{ _ ;� IV/ ._'
i ° c
1 r s
j c.-
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:.1.
Total
Sump pumps
Foundation drains
Roof drains
41011
Cit of Ea pp
Residential Sanitary Sewer Service
Compliance Inspection
Date / `_ • i /
Name
P1D Number
House Number
Alt native Mailing Add ress
4" to 6" Transition:
White Copy: Property Owner
.-. �_..
Time •
Disk #
! 1 ) Street Name
r � .
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
0
O
O
0
0
O Pm
Non - Compliance
-
Number of stacks
Length of Service:
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Phone
Time
I
i
O am
•
• ,_O pm
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
For information call 651.470.2788
Roots
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Entered S. L at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Sump pumps
f f.r.
� � c,
. r �. C..
Foundation drains
i
, '
Roof drains
i
City at Fia an
Residential Sanitary Sewer Service
Compliance Inspection
'
9 1
I
Date
x2)
Name ✓ r :� /o Disk # -
PID Number
House Number
Damaged Pipe
Transition
4" to 6" Transition:
/ J
Compliance
O No foundation drain connection
f ® No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
Time ti
• J o,am
Oviier10ccupant Signature
pm
Alternative Mailing Address
Street Name _ ifi i3 /I
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
• O am
Time `:3 • pm
# /1
Phone
t-
Obstruction
Unable to push past
feet
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 Number of stacks _ F . Entered S L.at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
▪ •
Final Cleanout:
Total
Number Discharged
Correctly Incorrectly Unknown
Notes
, I.."( }
s'
Pink Copy: SEH
ra