4615 1_2 Penkwe Way - Inspection FormCity of Ea
Y p,an
Residential Sanitary Sewer Service
Compliance Inspection
Date I ! 1
PID Number
House Number J 2 Street Name
Alternative Mailing Address
For information call 651.470.2788
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
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time - •
Owner/Occupant Signature
J.a 2 !
am
pm
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 PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ..--
1 1
7 7 _
Length of Service:
Yellow Copy: City of Eagan
Phone
Record Number
7.,
•
- Time {5 •
in ector Signature
Obstruction
Unable to push past
feet,
Final Cleanout:
am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S at
Pink Copy: SEH
Total
N otes
(/ ( 7
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r.
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
3..
f ; ` i f
t .--
i1 r
- -
Foundation drains
/
Roof drains
, V
City of Ea
Y p,an
Residential Sanitary Sewer Service
Compliance Inspection
Date I ! 1
PID Number
House Number J 2 Street Name
Alternative Mailing Address
For information call 651.470.2788
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
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time - •
Owner/Occupant Signature
J.a 2 !
am
pm
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 PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ..--
1 1
7 7 _
Length of Service:
Yellow Copy: City of Eagan
Phone
Record Number
7.,
•
- Time {5 •
in ector Signature
Obstruction
Unable to push past
feet,
Final Cleanout:
am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S at
Pink Copy: SEH