4655 Penkwe Way - Inspection FormSump pumps
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Foundation drains
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Roof drains
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Cit y of Ia i
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
„„, Disk #
PID Number
House Number
/SagiPipe Deflection
e ad
Time;•
OwnerlOccupant Signature
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
f ` sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Non - Compliance
LI
Damaged Pipe
11
Transition 1-4
4" to 6 "Transition:
White Copy: Property Owner
am
Pm
Number of stacks
Length of Service:
Record Number
Street Name / /
Alternativef"IailingAddre
if 1
tt J
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Yellow Copy: City of Eagan
Entered SL. at
-�r
•
Time • m
Phone /
inspector Signature
For information call 651.470.2788
Obstruction
,z 7
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Total
Number Discharged
Correctly
ncorrectly
Unknown
Notes
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