4607 1_2 Penkwe Way - Inspection FormAll. •Ptta a
Y a Compliance Inspection
Residential Sanitary Sewer Service
Date l
Name/, J L2� Disk #
PID Number
House Number
Alternative MailingAddress
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit noc connected to
sanitary sewer
O Sump purnp properly piped
O No sump pump
■
Service Lateral Inspection Findings Number of stacks `/ Entered S L at - ?
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
II
Transition �'' T _ i '7 .-.
f ° ' a r 77)
y�
. I P„h ViCe:'�f
4" to 6" Transition:
r
White Copy: Proper ty Owner
• �}/�' am
Time • `-/ p pm
f
?2Street Name
v f
Owner /Occupant Signature
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
6� lr
Yellow Copy: City of Eagan
Record Number
Phone -
• ,V am
Time • o pm
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
7)
2
Final Cleanout: 1•"
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
(,,.../ / / ( 1 /
�i" -
1 f /
0 �.✓7)
-- 7") '
`( 4r
{`�/ ` 1..e � - Y rC. r
` � - 6 -,..,
!I47 r 1 % 1 C._ `
Number
Discharged,
Correctly
Incorrectly Unknown
Sump pumps
! �
� .
r .) ,/ ;
/ , ` t -
G
- - I-?
Foundation drains
Roof drains
' )
L�
All. •Ptta a
Y a Compliance Inspection
Residential Sanitary Sewer Service
Date l
Name/, J L2� Disk #
PID Number
House Number
Alternative MailingAddress
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit noc connected to
sanitary sewer
O Sump purnp properly piped
O No sump pump
■
Service Lateral Inspection Findings Number of stacks `/ Entered S L at - ?
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
II
Transition �'' T _ i '7 .-.
f ° ' a r 77)
y�
. I P„h ViCe:'�f
4" to 6" Transition:
r
White Copy: Proper ty Owner
• �}/�' am
Time • `-/ p pm
f
?2Street Name
v f
Owner /Occupant Signature
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
6� lr
Yellow Copy: City of Eagan
Record Number
Phone -
• ,V am
Time • o pm
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
7)
2
Final Cleanout: 1•"
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH