4627 1_2 Penkwe Way - Inspection Form 1
Residential Sanitary Sewer Service
~r Compliance Inspection
Date 1 I Time 07; c a° Record Number frr
Name i~J~ff Ho 1-1Zisk Oj> 0S a PM
LJ
PID Number
House Number qZ 'Str'eet Name Il
Alternative_Mailing,Mdr•ess Ph ne
Owner/Occupant Signature Inspector Signature
For information call 651.470.2788
conwplianC_i . Non-compliance Obstruction No Access
LNo ion drain connection O Clear, water, connections to Unable to push past O No one in
ain connection sanitary sewer feet.
O Access to service
O Service lateral defects lateral needed
t connected to O Defective manholes
er O Inspection
O Sump pump connected to sanitary refused
properly piped sewer
umeu p J~ O Flexible sump pump piping
Service Lateral Inspection Findings Number- of stacks { Entered S L at -J T:67'e
Roots
r
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection rf°
Damaged Pipe
flk I ' ^y q '
Transition_
4" to 6"Transition: Length of Service:= Final Cleanout:rl/:s~.>~i rJ
Number Discharged I r otes r r-3
Total Correctly Incorrectly Unknown
Sump pumps 1, , `e .-C T f ~
Foundation drains f r
Roof drains
e
j ~
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH