4681 Penkwe Way - Inspection Form
Residential Sanitary Sewer Service
c1ty or 1! Compliance Inspection
Date c 1 Time : • e p pm Record Number
arn
Name I Disk Time T ~ p pm
PID Number ~J
House Number - i Street Name
Alternative Mailing Address Phone Z
!
Ownerl0ccupant Signature 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
t, sanitary sewer feet
,.Q No roof drain connection O Access to service
O Service lateral defects lateral needed
O Sump pit not connected to O Defective manholes
sanitary sewer O Inspection
,K O Sump pump connected to sanitary
.0 Sump pump properly piped sewer, refused
r
A No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots.
Poor Pipejoints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
s
Transition;~~~:.?-
c
4" to 6" Transition: Length of Service: f' Final Cleanout:':
Notes
Number Discharged ~x
Total Correctly Incorrectly Unknown f r
Sump pumps A'
Foundation drains 1t
Roof drains
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH