4613 1_2 Penkwe Way - Inspection Form4 City of tarn
Residential Sanitary Sewer Service
Compliance Inspection
Date )-4-1 F 3
Name .,
PID Number
House Number i 1 ('7 _ 2 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
g No roof drain connection
ti r
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
l7 � %)# am
Time ` � • 0 Pm
Owner /Occupant Signature
Transition
n
1
Yellow Copy: City of Eagan
Record Number.
Phone
Time .> • ` o pm
i
Inspector Signature
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
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks �/ Entered S. L. at
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
e
Final Cleanoutcr.'- i
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes �,
% ;� fr — / J� C, c . '�
o . --a S-
�^ l r J 1 „ ;
? f`y ' 1 r ; ' i
Total
Sump pumps
. 3 ��
` � J
'--- i , X2 /1
f
Foundation drains
=Erg
NUMMI
Roof drains
4 City of tarn
Residential Sanitary Sewer Service
Compliance Inspection
Date )-4-1 F 3
Name .,
PID Number
House Number i 1 ('7 _ 2 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
g No roof drain connection
ti r
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
l7 � %)# am
Time ` � • 0 Pm
Owner /Occupant Signature
Transition
n
1
Yellow Copy: City of Eagan
Record Number.
Phone
Time .> • ` o pm
i
Inspector Signature
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
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks �/ Entered S. L. at
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
e
Final Cleanoutcr.'- i
Pink Copy: SEH