4610 Penkwe Way - Inspection FormCity or an
Residential Sanitary Sewer Service
Compliance Inspection
L - ' / /13
Name //
PID Number
House Number
Date
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
§ag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
:Ram
Pm
Time /4•
I
Disk #
Street Name
CALLta
OwneilOccupant Signature
- A rT /___) ,
.
411 c
(1../
Yellow Copy: City of Eagan
Alternative Mailing Address
Non
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
Record Number 4
•
ime •
Inspector Signature
Obstruction
Unable to push past
feet.
am
pm
Phone ( 5! & -)e- g 6.7 5 --
For information call 651.470.2788
No Access
O No one in
o Access to service
lateral needed
O Inspection
refused
Service Laterll InsOction Findings Number of stacks 4 Entered S.L . at
Roots
-Length-of-Service: /7-) 7-7--- g 1 Final Cleanout: / -:'" ii i
-.----, -.--' :::p -
Pink Copy: SEH
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
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...-!--,
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7).;) F2.,74r—b—
_
-
-
Foundation drains
Roof drains
(
,. ......../
City or an
Residential Sanitary Sewer Service
Compliance Inspection
L - ' / /13
Name //
PID Number
House Number
Date
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
§ag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
:Ram
Pm
Time /4•
I
Disk #
Street Name
CALLta
OwneilOccupant Signature
- A rT /___) ,
.
411 c
(1../
Yellow Copy: City of Eagan
Alternative Mailing Address
Non
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
Record Number 4
•
ime •
Inspector Signature
Obstruction
Unable to push past
feet.
am
pm
Phone ( 5! & -)e- g 6.7 5 --
For information call 651.470.2788
No Access
O No one in
o Access to service
lateral needed
O Inspection
refused
Service Laterll InsOction Findings Number of stacks 4 Entered S.L . at
Roots
-Length-of-Service: /7-) 7-7--- g 1 Final Cleanout: / -:'" ii i
-.----, -.--' :::p -
Pink Copy: SEH