4605 1_2 Penkwe Way - Inspection FormI
Number Discharged
Notes e L/ f `r
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AJ A 1 / `> ; 1j 4 4''4 1(. e:c)
°
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
_�a.
Roof drains
%
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Residential Sanitary Sewer Service
Compliance Inspection
• y�-
Date / r � / ,4"; Time a • % p p m
Name jA/rie —S e Disk #
PID Number
House Number
Compliance
O No foundation drain connection
/No roof drain connection
J O Sump pit not connected to
J\
sanitary sewer
O Sump pump properly piped
No sump pump
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
9w
Transition I AAA' t`-
4" to 6" Transition:
White Copy: Proper ty Owner
Street Name
etl0ccup ' Signat(
Alternative Mailing Address
Non - Compliance
0
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
# 'Fi 1 1 - / Ag/ <(j Pvc_ 7.
Length of Service:
Yellow Copy: City of Eagan
Record Number
J L 3 YM_
• pram
Time Q 1 • C)C) o pm
hone
)
/7 Inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
Service Lateral Inspection Findings Number of stacks / Entered S L. at s7 "4 ( v
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: ifiv
Pink Copy: SEH