4619 Penkwe Way - Inspection FormSump pumps
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Foundation drains
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Roof drains
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4 11. City of Eapn
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 : - - 7 M . 1 _ /c)
• iteie Iv!r ? i Disk#
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PID Number
House Number t %7 Street Name
Alternative Mailing Address Phone (4- /.4.5
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f fri pector Signature
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"OwnerlOccupant Signature
For information call 65 1.470.2788
Compliance
O No foundation drain connection
°O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
PE No sump pump
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
31 —C) a
Time • O pm
0
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
Length of Service:
}
Yellow Copy: City of Eagan
Record Number
1
Obstruction
Unable CO push past
feet
Entered S L.at - '2'
l ar6 am
Time (t)" • o pm
i /
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Number Discharged
Total Correctly Incorrectly Unknown
Notes it
J
Pink Copy: SEH