4609 Penkwe Way - Inspection FormCif ai ba ap
Residential Sanitary Sewer Service
Compliance Inspection
Date t.� /5 1 i
Name 2/ 11+t
PID Number
House Number
Alternative Mailing Address
Ow ner /Occupant Signature
For information tall 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
V No sump pump
ti
• am
Time /C. • aQ t) pm
Disk #
Street Name
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipejoints
Mineral Deposits ]c]
Sag /Pipe Deflection f l •'"
Damaged Pipe
Transition au / ¼J ✓/� `
4" to 6 "Transition:
/ ' 4 .4.
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
1 r
Length of Service: L/
White Copy: Property Owner
Yellow Copy: City of Eagan
0
Record Number j
c
X 1'3 am
Time 10 • o pm
Phone rte' // 9:
/risfector Signature
Obstruction
Unable to push past
feet
Entered S.L,at ‘,NtirE...
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cieanout:
Pink Copy: SEH
Total
Notes _ 6,- 4,ar✓
`,
f
e ' FQ7-_ : .i
r`� :. 7,, a
i' ✓
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
/:.
Foundation drains
Roof drains
Cif ai ba ap
Residential Sanitary Sewer Service
Compliance Inspection
Date t.� /5 1 i
Name 2/ 11+t
PID Number
House Number
Alternative Mailing Address
Ow ner /Occupant Signature
For information tall 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
V No sump pump
ti
• am
Time /C. • aQ t) pm
Disk #
Street Name
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipejoints
Mineral Deposits ]c]
Sag /Pipe Deflection f l •'"
Damaged Pipe
Transition au / ¼J ✓/� `
4" to 6 "Transition:
/ ' 4 .4.
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
1 r
Length of Service: L/
White Copy: Property Owner
Yellow Copy: City of Eagan
0
Record Number j
c
X 1'3 am
Time 10 • o pm
Phone rte' // 9:
/risfector Signature
Obstruction
Unable to push past
feet
Entered S.L,at ‘,NtirE...
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cieanout:
Pink Copy: SEH