4629 Penkwe Way - Inspection Form4 11 " City of Ca an
Residential Sanitary Sewer Service
Compliance Inspection
Date r2 // lei 1 /0
Name ✓4/7 //4'V/ j ,,,,,, w Disk #
Time 0 -, 0 pm
PID Number
House Number ( / Street Name
Alternative Mailing Address Phone lla 7 ?
� :
Mineral Deposits Ye f•
4" to 6 "Transition: Af
White Copy: Property Owner
Owner /Occupant Signature
For information call 651.470.278$
Comptiance
O No foundation drain connection
: No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
SaglPipe Deflection
Damaged Pipe
Transition
Service Lateral Inspection Findings Number of stacks / Entered S L at
Roots
Poor Pipe Joints
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
Ord _ s ,. 6 ()
t
Z5
f/
Length of Service:
Yellow Copy: City of Eagan
0
Record Number l Y
Time
d'
Obstruction
Unable to push past
feet
7/ inspector Signature
' #O am
' pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cieanout:���� �.
Pink Copy: SEH
Total
Notes
0 A, '3L
..,.,.r/4''
t)Cj
e
__
.Y .r 7 r s
,;
!.'i -1��.� G 77,
Y1J .a' /14,0W.)::}
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7
'�`' . .
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
'
_
Foundation drains
J'
Roof drains
4 11 " City of Ca an
Residential Sanitary Sewer Service
Compliance Inspection
Date r2 // lei 1 /0
Name ✓4/7 //4'V/ j ,,,,,, w Disk #
Time 0 -, 0 pm
PID Number
House Number ( / Street Name
Alternative Mailing Address Phone lla 7 ?
� :
Mineral Deposits Ye f•
4" to 6 "Transition: Af
White Copy: Property Owner
Owner /Occupant Signature
For information call 651.470.278$
Comptiance
O No foundation drain connection
: No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
SaglPipe Deflection
Damaged Pipe
Transition
Service Lateral Inspection Findings Number of stacks / Entered S L at
Roots
Poor Pipe Joints
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
Ord _ s ,. 6 ()
t
Z5
f/
Length of Service:
Yellow Copy: City of Eagan
0
Record Number l Y
Time
d'
Obstruction
Unable to push past
feet
7/ inspector Signature
' #O am
' pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cieanout:���� �.
Pink Copy: SEH