4627 Penkwe Way - Inspection FormCity of Fa
Residential Sanitary Sewer Service
Compliance Inspection
Name r f-. y ; ` -':e1� Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
/ No roof drain connection
,
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
6 No sump pump
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
/'
Transition ± / ), '
/
/ �\ -•-, //
7
. j ,,,
4" to 6 "T ansition:
White Copy: Property Owner
am
Time 4 — pm
r
; Street Name
Owner /Occupant Signature
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks Entered S. at
Length of Service:
Yellow Copy: City of Eagan
7 L %` _ 1
//I
f� f
1
Record Number l
Obstruction
Unable to push past
feet
e /
Time
• - s - 0 am
• D Prr
Inspector Signature
., 3 Final Cleanout:
No Access
O No one in
•
) f
▪ 777
O Access to service
lateral needed
O Inspection
refused
_= !
Pink Copy: SEH
Notes
r , f l : '
: ) � �
r
,
1
,__,,
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of Fa
Residential Sanitary Sewer Service
Compliance Inspection
Name r f-. y ; ` -':e1� Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
/ No roof drain connection
,
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
6 No sump pump
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
/'
Transition ± / ), '
/
/ �\ -•-, //
7
. j ,,,
4" to 6 "T ansition:
White Copy: Property Owner
am
Time 4 — pm
r
; Street Name
Owner /Occupant Signature
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks Entered S. at
Length of Service:
Yellow Copy: City of Eagan
7 L %` _ 1
//I
f� f
1
Record Number l
Obstruction
Unable to push past
feet
e /
Time
• - s - 0 am
• D Prr
Inspector Signature
., 3 Final Cleanout:
No Access
O No one in
•
) f
▪ 777
O Access to service
lateral needed
O Inspection
refused
_= !
Pink Copy: SEH