4641 1_2 Penkwe Way - Inspection Form4 City of li ao
Residential Sanitary Sewer Service
Compliance Inspection
Date / / Time • o am
Name Disk #
PID Number
11
House Number 2 4/5,. J ) Street Name
Alternative MailingAddress
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 Number of stacks
White Copy: Propenty Owner
OwnerlOccupant Signature
pm
Non - Compliance
Yellow Copy: City of Eagan
t
Record Number "
Time
f =sue o am
a •
�-7 • s � pm
/41
Phone i J 2
Obstruction
inspector Signature
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at° =
r l )
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1, � J_. f 1, ! r
Tr ansition '. `} - i '" ?s 2 4
4" to 6" Tr ansition:
Final Cleanout: 1.4
Pink Copy: SEH
Total
Notes
-
"� "" `�
-,> .--= J � `� - r'''''—' r-
7
C
;
'
l
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
- C r_
ma c - , n
i/ I w
._. f
-�
Foundation drains
'
Roof drains
4 City of li ao
Residential Sanitary Sewer Service
Compliance Inspection
Date / / Time • o am
Name Disk #
PID Number
11
House Number 2 4/5,. J ) Street Name
Alternative MailingAddress
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 Number of stacks
White Copy: Propenty Owner
OwnerlOccupant Signature
pm
Non - Compliance
Yellow Copy: City of Eagan
t
Record Number "
Time
f =sue o am
a •
�-7 • s � pm
/41
Phone i J 2
Obstruction
inspector Signature
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at° =
r l )
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1, � J_. f 1, ! r
Tr ansition '. `} - i '" ?s 2 4
4" to 6" Tr ansition:
Final Cleanout: 1.4
Pink Copy: SEH