4641 Penkwe Way - Inspection Form41111111- • Cit a ' Ca p
Residential Sanitary Sewer Service
Compliance Inspection
Date 4 /�..5 1 Jai' Time s3 7: cb p p m
Name �i �l JvJ. ; ;l_� i/ Disk #
PID Number //
House Number 4 / ��7 . Street Name 1 4,1_"J /.�*
Alternative Mailing Address e -- .? ° °"
Owner /Occupant Signature
Compliance
O No foundation drain connection
Q' No roof drain connection
9 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
so No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Transition
4" to b" Transition:
White Copy: Property Owner
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
Damaged Pipe
r
!
Length of Service:
Yellow Copy: City of Eagan
Record Number
4
Phone
>
>.
Time 0 fkam pm
Inspector Signature
Obstruction
Unable to push past
feet.
-1
No Access
O No one in
Entered S at 5'74 ._. C�
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Notes
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C-477:
OF e -
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/; r� r 0 r r-
Number
Discharged
Total
Correctly
Incorrectly Unknown
Sump pumps
t.�/..
__
.„
Foundation drains
Roof drains
..�.
41111111- • Cit a ' Ca p
Residential Sanitary Sewer Service
Compliance Inspection
Date 4 /�..5 1 Jai' Time s3 7: cb p p m
Name �i �l JvJ. ; ;l_� i/ Disk #
PID Number //
House Number 4 / ��7 . Street Name 1 4,1_"J /.�*
Alternative Mailing Address e -- .? ° °"
Owner /Occupant Signature
Compliance
O No foundation drain connection
Q' No roof drain connection
9 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
so No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Transition
4" to b" Transition:
White Copy: Property Owner
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
Damaged Pipe
r
!
Length of Service:
Yellow Copy: City of Eagan
Record Number
4
Phone
>
>.
Time 0 fkam pm
Inspector Signature
Obstruction
Unable to push past
feet.
-1
No Access
O No one in
Entered S at 5'74 ._. C�
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH