4631 Penkwe Way - Inspection Form4111111
City alla ui
Residential Sanitary Sewer Service
Compliance Inspection
Date 2 4/ J 1 f Time
Nam aJd !!'ir - edhe Disk#
HD Number
House Number
Alternative Mailing Address Phone
l
Street Name
Owner /Occupant Signature
For information call 65 1.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral inspection Findings
Damaged Pipe , 1
Transition ; p 5-
7 `.
4" to 6" Transition:
White Copy: Property Owner
c "t Q am
• l' pm
C✓
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
Record Number
'Inspector Signature
Number of stacks ", Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
•leer►gth»of&r . !
Yellow Copy: City of Eagan
•
ime •
Obstruction
Unable to push past
feet
�f i p p m
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
{ ' 5' t
Final Cleanout:. = 3 -7 ; "
! i
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
, -, fic -
{
• 3 � �, , i f f ' i
�-'
�t' i G:. ,)1,y f+ F`
Total
Sump pumps
wry
�`
' lf.�
m i
`- r.
Foundation drains
Roof drains
-
�q
4111111
City alla ui
Residential Sanitary Sewer Service
Compliance Inspection
Date 2 4/ J 1 f Time
Nam aJd !!'ir - edhe Disk#
HD Number
House Number
Alternative Mailing Address Phone
l
Street Name
Owner /Occupant Signature
For information call 65 1.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral inspection Findings
Damaged Pipe , 1
Transition ; p 5-
7 `.
4" to 6" Transition:
White Copy: Property Owner
c "t Q am
• l' pm
C✓
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
Record Number
'Inspector Signature
Number of stacks ", Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
•leer►gth»of&r . !
Yellow Copy: City of Eagan
•
ime •
Obstruction
Unable to push past
feet
�f i p p m
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
{ ' 5' t
Final Cleanout:. = 3 -7 ; "
! i
Pink Copy: SEH