4602 1_2 Penkwe Way - Inspection Form410.
cit of Fain
Residential Sanitary Sewer Service
Compliance Inspection
Date L 1 4 a
Name ,k4/„ r i
i
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
4" to 6 "Transition:
White Copy: Property Owner
Time
PID Number
House Number L 4 c ,Street Name
isk #
r ? ner /Occupant Signature
Service Lateral Inspection Findings
• c..- o am
• pm
L
Non - Compliance
O Clear water connections to
sanitary sewer
O Ser vice lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Time
•
• _
Alternative Mailing Address Phone /'�
•1 r'o eF ry e
am
pm
'Inspector Signature
Obstruction
Unable to push past
feet
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r 1 �� w
Number of stacks 1 Entered S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
{
Final Cleanout $ 5 4
Pink Copy: SEH
Number
Correctly
NotF r
Discharged �'/ #
Incorrect Unknown 2 -, 7- 7-
Total
Sump pumps
,f
- y ° "% c ' ? ''f %:4„ /''
Foundation drains
1
�
Roof drains
r f
410.
cit of Fain
Residential Sanitary Sewer Service
Compliance Inspection
Date L 1 4 a
Name ,k4/„ r i
i
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
4" to 6 "Transition:
White Copy: Property Owner
Time
PID Number
House Number L 4 c ,Street Name
isk #
r ? ner /Occupant Signature
Service Lateral Inspection Findings
• c..- o am
• pm
L
Non - Compliance
O Clear water connections to
sanitary sewer
O Ser vice lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Time
•
• _
Alternative Mailing Address Phone /'�
•1 r'o eF ry e
am
pm
'Inspector Signature
Obstruction
Unable to push past
feet
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r 1 �� w
Number of stacks 1 Entered S,L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
{
Final Cleanout $ 5 4
Pink Copy: SEH