4632 Penkwe Way - Inspection FormC .<'
Number
Correctly
Discharged
Incorrectly Unknown
11111
Notes tVkA' Ai -', :v�r C' ,;�-
r` -r .
`./ f Y r
-/V-17 r
! 1 / / , C z 7'
Total
Sump pumps
Foundation drains
r te -° -T
drains
Jar
,.r -
® Roof
40-
City of Fa u
Residential Sanitary Sewer Service
Compliance Inspection
Date 4 1 1 /
Name'/VC 1,/1"1 .. r.fDD9k#
PID Number
House Number Street Name
Compliance
No foundation drain connection
;No roof drain connection
Q' pit not connected to
sanitary sewer.
`O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
/f-
Transition
n
4" to 6 "Transition:
Owner /Occupant Signature
White Copy: Property Owner
• ?2-. o am
Time • .5 pm
0
Number of stacks
4/4-1
Alternative Mailing Address
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
Z/2
i " l I
f `F
/ Inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S„L,at -'
o am
•
• , ET A Pm
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: �.e,f
Pink Copy: SEH
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