4631 1_2 Penkwe Way - Inspection FormCity of Caaa
Residential Sanitary Sewer Service
Compliance Inspection
Date Oi 1 i -r1 / a
Name i F4Z1 /A jai
PO Number
House Number
Alternative Mailir Address
• am
T i m e ' o pm
Disk #
o'wer/Occupant Signature
0
Street Name
r eftik__. 1
Record Number 1
•
Time • C?
' fz 6
Phone
,// inspector Signature
pram
0 pm
For information call 651.470.2788
Compliance
i ikiClo foundation drain connection 0
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
PvC , ( 1/ a/
Non - Compliance
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
Length of Service: q 7
Yellow Copy: City of Eagan
Obstruction No Access
Unable to push past 0 No one in
feet
O Inspection
refused
`'
Entered S.L at --- ' ; %/C-- t-
P
O Access to service
lateral needed
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 v A i ( r
Final Cleanout: �� r� 4..4/
Pink Copy: SEH
Total
Notes ...- 'Eras / s.0 6
i`.f". J_ f
r ,._- ' "
( ,r„ : r .�" '
- "`
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
4. m- -"
Foundation drains
Roof drains
_ - p-- ..°. --.-�
w
City of Caaa
Residential Sanitary Sewer Service
Compliance Inspection
Date Oi 1 i -r1 / a
Name i F4Z1 /A jai
PO Number
House Number
Alternative Mailir Address
• am
T i m e ' o pm
Disk #
o'wer/Occupant Signature
0
Street Name
r eftik__. 1
Record Number 1
•
Time • C?
' fz 6
Phone
,// inspector Signature
pram
0 pm
For information call 651.470.2788
Compliance
i ikiClo foundation drain connection 0
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
PvC , ( 1/ a/
Non - Compliance
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
Length of Service: q 7
Yellow Copy: City of Eagan
Obstruction No Access
Unable to push past 0 No one in
feet
O Inspection
refused
`'
Entered S.L at --- ' ; %/C-- t-
P
O Access to service
lateral needed
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 v A i ( r
Final Cleanout: �� r� 4..4/
Pink Copy: SEH