4643 Penkwe Way - Inspection FormsLlty at Earn
Residential Sanitary Sewer Service
Compliance Inspection
Date an , 7 i /0
a 7�
Name /s'7'tl i 'ytrr Disk #
PID Number
House Number 2 4 1 V Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Surnp pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Proper ty Owner
Time JO • o pm
Qtisrnerloupant Signature
)
Non - Compliance
O
O
O
O
O
Clear• water connections to
sanitary sewer
Service lateral defects
Defective manholes
Surrp. connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone
%
inspector Signature
Obstruction
Unable to push past
feet
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
• p am
• O pm
N . Access
No one in
Access to service
lateral needed
O Inspection
refused
Notes
3 ,�.,�r
i / �.-�, f
�rS
Pink Copy: SEH
Total
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Llty at Earn
Residential Sanitary Sewer Service
Compliance Inspection
Date an , 7 i /0
a 7�
Name /s'7'tl i 'ytrr Disk #
PID Number
House Number 2 4 1 V Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Surnp pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Proper ty Owner
Time JO • o pm
Qtisrnerloupant Signature
)
Non - Compliance
O
O
O
O
O
Clear• water connections to
sanitary sewer
Service lateral defects
Defective manholes
Surrp. connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone
%
inspector Signature
Obstruction
Unable to push past
feet
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
• p am
• O pm
N . Access
No one in
Access to service
lateral needed
O Inspection
refused
Notes
3 ,�.,�r
i / �.-�, f
�rS
Pink Copy: SEH
4. 4_ of lia an
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 / I /0
j
Name ) /AV ft/W ,g
PID Number
House Number 4 / Street Name
Alternative Mailing Address Phone
z,
y; r i rr l)
Owner /Occupan Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
").O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
g No sump pump
Y�.
Service Lateral Inspection Findings
Roots
Poor Joints
Mineral Deposits 52 '?"
Sag /Pipe Deflection —
Damaged Pipe
• ® ,dam
Time rO pm
Disk #
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
Transition '-! ; ". AS _I
4" to 6 "Transition:
White Copy: Property Owner
r
0
Length of Service:
Yellow Copy: City of Eagan
Record Number
c
•3 o'am
Time O pm
(tri) 7y
j /
/Inspector Signature
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 \1?'4 C
Final Cleanout: v r�E�
Pink Copy: SEH
Number
Total Correctly
Discharged
Incorrectly
Unknown
Notes — u. t.-e 4:,.."--t- a .1, . c-
r cT. -„
` ' i ,.t 'l i (e 7 ("' e
. . � ✓?� 7 1 7 , ,
. ^ -rte {
Sump pumps
-11111
a `" -
Foundation drains
Roof drains
,--.
Ell
4. 4_ of lia an
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 / I /0
j
Name ) /AV ft/W ,g
PID Number
House Number 4 / Street Name
Alternative Mailing Address Phone
z,
y; r i rr l)
Owner /Occupan Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
").O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
g No sump pump
Y�.
Service Lateral Inspection Findings
Roots
Poor Joints
Mineral Deposits 52 '?"
Sag /Pipe Deflection —
Damaged Pipe
• ® ,dam
Time rO pm
Disk #
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
Transition '-! ; ". AS _I
4" to 6 "Transition:
White Copy: Property Owner
r
0
Length of Service:
Yellow Copy: City of Eagan
Record Number
c
•3 o'am
Time O pm
(tri) 7y
j /
/Inspector Signature
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 \1?'4 C
Final Cleanout: v r�E�
Pink Copy: SEH