4614 1_2 Penkwe Way - Inspection Form411bf.
City off'I a
Residential Sanitary Sewer Service
Compliance Inspection
Date) —1 / / f
}
Name ,
House Number
PID Number
Alternative Mailing Address
Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
, sanitary sewer
O Sump pump properly piped
O No sump pump
Time 4
For information call 651.470.2788
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe )) I
Transition
4" to b " Transition:
White Copy: Property Owner
Disk #
/9
am
pm
Number of stacks
/
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: ) (1
Yellow Copy: City of Eagan
Record Number
[-],„ Time
Entered S L at
Obstruction
Unable to push past
feet
)AJ ) 11/ 1 1
Phone . c51 f (r °�✓?T
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
arrr
Pm
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
( I ,C t i� J /)
S"' ,/
Total
Sump pumps
4
_4,-
r C7
7
t l C� e (3,,,,-,' j -� � G "
hL! / IA✓" e__. g kvit(kei
ci
f
Foundation drains -
Roof drains 11111
1
411bf.
City off'I a
Residential Sanitary Sewer Service
Compliance Inspection
Date) —1 / / f
}
Name ,
House Number
PID Number
Alternative Mailing Address
Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
, sanitary sewer
O Sump pump properly piped
O No sump pump
Time 4
For information call 651.470.2788
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe )) I
Transition
4" to b " Transition:
White Copy: Property Owner
Disk #
/9
am
pm
Number of stacks
/
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: ) (1
Yellow Copy: City of Eagan
Record Number
[-],„ Time
Entered S L at
Obstruction
Unable to push past
feet
)AJ ) 11/ 1 1
Phone . c51 f (r °�✓?T
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
arrr
Pm
Pink Copy: SEH