4633 1_2 Penkwe Way - Inspection FormSump pumps
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Foundation drains
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'
Roof drains
City of a an
Residential Sanitary Sewer Service
Compliance Inspection
Date L / 2 1 1
Name
PID Number
House Number ,L7L <Street Name
Alternative Mailing Address
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - .r
4" to 6" Transition:
White Copy: Property Owner
Time
J �n
j Dislt #
rlOccupant Signature
Service Lateral Inspection Findings
Total
saw V
41 pm
1
For information call 651.470.2788
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
Number of stacks 4 Entered S L.at
Len f�i of 5e��
Number Discharged
Correctly Incorrectly Unknown
-/".)
1 � 7
Record Number
- Time
Phone
Obstruction
Unable to push past
feet.
' am
JJ .
!/'7s O pm
inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
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Yellow Copy: City of Eagan Pink Copy: SEH
5
Final Cleanout: l 2 . "
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