4644 Penkwe Way - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date
Name 14
PD Number
House Number
Alternative Mailing Address
4" to 6 "Transition:
'14}7 Disk #
)7W/ ) Street Name
• -. 0 am
Time / ._ _X pm
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
O
O
O
0
0
For information call 651.470.2788
Non - Compliance
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
White Copy: Property Owner
Time
Yellow Copy: City of Eagani ?('
Record Number
Obstruction
Unable to push past
feet
Qtes
J o
( - ;=;
Final Cleanout:
O am
• O pm
Phone ‹ a 1' f36r -, 1
•
Inspector Signature
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S L at
•
iG
Cppy: SEH
Total
IN
NI
Number
Discharged
Correctly
Incorrectly
!
Unknown
-
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name 14
PD Number
House Number
Alternative Mailing Address
4" to 6 "Transition:
'14}7 Disk #
)7W/ ) Street Name
• -. 0 am
Time / ._ _X pm
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
O
O
O
0
0
For information call 651.470.2788
Non - Compliance
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
White Copy: Property Owner
Time
Yellow Copy: City of Eagani ?('
Record Number
Obstruction
Unable to push past
feet
Qtes
J o
( - ;=;
Final Cleanout:
O am
• O pm
Phone ‹ a 1' f36r -, 1
•
Inspector Signature
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S L at
•
iG
Cppy: SEH