4654 Penkwe Way - Inspection Form
Residential Sanitary Sewer Service
City I Ir Compliance Inspection
• C oar
Datellt Time .__-r- m Record Number
Name 6 /,1f Disk # j J ® Time S O Prri
PID Number 1
1f`~
House Number, Street Name
Alternative Mailing Address / Phone
OwnerlOccupont Signature »~~=T Inspector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
O No foundation drain connection O Clear water connections to Unable to push past O No one in
IVo roof drain connection sanitary sewer feet O Access to service
O Service lateral defects lateral needed
/Sump pit not connected to O Defective manholes sanitary sewer O Sump pump connected to sanitary O Inspection
refused
O Sump pump properly piped sewer
No sump pump O Flexible sump pump piping -
Service Lateral Inspection Findings Number, of stacks ( Entered S L at
Roots
Poor Pi pe joints
Mineral Deposits
Sag/Pipe Deflection`
Damaged Pipe
Transition ~ f
i
_ (1A/ i C_
4" to b" Transition: Length of Service: Final Cleanout:~
Notes
,~it/"~
J^
Number Discharged
Total Correctly Incorrectly Unknown
Sump pumps
Foundation drains t
Roof drains f,
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH