4672 Penkwe Way - Inspection FormResidential Sanitary Sewer Service
<, City f h Compliance Inspection
� p pectllon
Date/ 1 - 1 /7 1 Time
Name < Disk #
PID Number
House Number 2Str•eet Namei i
Phone _ 7) 274
Alternative Mailing Address ' `{ -f ! { /VtiV
White Copy: Property Owner
- ceup r Signature
e rOlj 0, a
Pm
Record Number.
Yellow Copy: City of Eagan
u '
am
. Inspector Signature
g' Pink Copy: SEH
For information call 65 1.470.2788
Compliance
O No foundation drain connection
No roof drain connection
r Sump pit not connected to
` sanitary sewer
O Sump pump properly piped
O No sump pump
Non - Compliance
0 Clear water connections to
sanitary sewer
0 Service lateral defects
0 Defective manholes
0 Sump pump connected to sanitary
sewer
0 Flexible sump pump piping
Obstruction
Unable to push past
feet.
No Access
0 No one in
0 Access to service
lateral needed
0 Inspection
refused
Service Lateral Inspection Findings
P
Roots
Number of stacks_
Entered S L at =, - .� r
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection (4-' / i `
=/- -
Damaged Pipe
!',
" •- � , `• , d ' ..-
6 °-.4.- 9 ���� . ^ " ' /
Transition / r
� I -,-/ 1 --I-7-7
-
_� _ i
) 2 ff ff f ` ?� / :
-
r
Service: f ,_ 1 ' - Final Cleanout:
° � , -- f t :ter
r . •
l
/ J
4" to 6 "Transition:
Length of
Total
Notes
,-. r I °' -' ! • _ c-
= # f
__-- ,/' r'
/ • e. ; . Jj r�, E f
_ .. t ° =,
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
P- r�
> 6 i (
/
/
(, e--,
Foundation drains
�
I �
-
Roof drains
,
Residential Sanitary Sewer Service
<, City f h Compliance Inspection
� p pectllon
Date/ 1 - 1 /7 1 Time
Name < Disk #
PID Number
House Number 2Str•eet Namei i
Phone _ 7) 274
Alternative Mailing Address ' `{ -f ! { /VtiV
White Copy: Property Owner
- ceup r Signature
e rOlj 0, a
Pm
Record Number.
Yellow Copy: City of Eagan
u '
am
. Inspector Signature
g' Pink Copy: SEH