4645 1_2 Penkwe Way - Inspection Form4 411
City of Eap,an
Residential Sanitary Sewer Service
Compliance inspection
Date 1 )( Time
Name )I) ,/;11-)(ff, Disk #
MD Number
� �
House Number - �, t ,' f
Street Name
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
T AIV I A 14 P. AJ(4k
Owner /Occupant Signature
Compliance
O No foundation drain connection
Service Lateral Inspection Findings
Transition /' 2 '47
' -
1-4-P )
_•Dam
.�t • pm
Non-Compliance
O
O
O
O
0
Number of stacks
Yellow Copy: City of Eagan
Alternative Mailing Address
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Entered S Lat
Record Number
Time • •
inspector Signature
Obstruction
Unable to push past
feet.
Dam
Pm
Phone •.��— F ,
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe �.
Final Cleanou :
Pink Copy: SEH
Number
Correctly
Discharged
Notes
= J
- i j� , ;-; i � ,.;b
'
`� ' ` !
/
Total
Incorrectly
Unknown
Sump pumps
.,. .
i
, i
I�< � ��
'° "
Foundation drains
¥
Roof drains
y
4 411
City of Eap,an
Residential Sanitary Sewer Service
Compliance inspection
Date 1 )( Time
Name )I) ,/;11-)(ff, Disk #
MD Number
� �
House Number - �, t ,' f
Street Name
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
T AIV I A 14 P. AJ(4k
Owner /Occupant Signature
Compliance
O No foundation drain connection
Service Lateral Inspection Findings
Transition /' 2 '47
' -
1-4-P )
_•Dam
.�t • pm
Non-Compliance
O
O
O
O
0
Number of stacks
Yellow Copy: City of Eagan
Alternative Mailing Address
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Entered S Lat
Record Number
Time • •
inspector Signature
Obstruction
Unable to push past
feet.
Dam
Pm
Phone •.��— F ,
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe �.
Final Cleanou :
Pink Copy: SEH