4618 Penkwe Way - Inspection FormSump pumps
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Foundation drains
N I 1
a
Roof drains
Or
City of Fa an
Residential Sanitary Sewer Service
Compliance Inspection
Date 2( 71 Z2' / ./G
Name , 4/C
PID Number
House Number
Alternative Mailing Address
Compliance
0 No foundation drain connection
ONS.imp pit not connected to
Sanitary sewer
0 Sump pump properly piped
, No sump pump
Service Lateral Inspection Findings
Transition
o roof drain connection
4" to 6" Transition:
White Copy: Property Owner
Disk #
e /4/ Street Name ,/-! .
•
Time • CX C O pm
Owner /Occupant Signature
N A
Total
2
Phone r g"? 7/
4(7/
J
For information call 651 A70.2788
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1 1 / q '. f ,
Length of Service.
Number Discharged
Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
C
Record Number
Entered S L at r7.-- !"r
Notes - La - , �"f✓c ; ;t ' ; fit' ----(2-,72
TVc,, f -r
F
Lc; CJrric
Obstruction
Unable to push past
feet .
p am
Time • ej pm
//inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: / r /
Pink Copy: SEH
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