4617 Penkwe Way - Inspection Form`
City of Ea go
Residential Sanitary Sewer Service
Compliance Inspection
-1
Date
Name :- /�i Disk 14 a2
PID Number
o� ! /
House Number ( 1 ! Street Name
Alternative Mailing Address
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::
Owner/ upant Signature
White Copy: Property Owner
d'L am
Time J 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
j j„augt e-
Yellow Copy: City of Eagan
Record Number
Wj la Time tee %
Phone
Inspector Signature
Obstruction
Unable to push past
feet
Number of stacks Entered S.L.at
am
0 pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition _: �' �` ? i i � ✓
Final Cleanout:,_ ? . 7 L 24- ir
Pink Copy: SEH
Total
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
C) / .� l 1 ()( ! 1 �4 C2(2
5 , . j " + !
I )
'- I c i - C--- :: 7 - ` _ :4 "-
Sum um s
p P P
% r d /
�'/
r, -4--
Foundation drains
Roof drains
`
City of Ea go
Residential Sanitary Sewer Service
Compliance Inspection
-1
Date
Name :- /�i Disk 14 a2
PID Number
o� ! /
House Number ( 1 ! Street Name
Alternative Mailing Address
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::
Owner/ upant Signature
White Copy: Property Owner
d'L am
Time J 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
j j„augt e-
Yellow Copy: City of Eagan
Record Number
Wj la Time tee %
Phone
Inspector Signature
Obstruction
Unable to push past
feet
Number of stacks Entered S.L.at
am
0 pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition _: �' �` ? i i � ✓
Final Cleanout:,_ ? . 7 L 24- ir
Pink Copy: SEH