4639 1_2 Penkwe Way - Inspection Form411
City of falan
Residential Sanitary Sewer Service
Compliance Inspection
Date / /Y
Name ..ri 4/tDisk #
• Qam
Time /..s
0
PID Number
House Number 9gi/C Street Name
Alternative Mailing Address
Compliance
0 No foundation drain connection
ID roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No surnp pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Pi operty Owner
Owner/OccupandSignature
NOlii-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
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time i Z
Phone
Obstruction
Unable to push past
feet
,/?inspector Signature
0 am
F‘` Pm
For information call 651.470.2788
No Access
O No one in
Enter ed S L at 37,4c46.7- Ct.')
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
( 77 ,
Sag/Pipe Deflection
Damaged Pipe
Transition L/ /1-(cf Pt,c
Viv
Final Cleanout:
Pink Copy: SEH
Total
Notes
,
...„--
i r-- i<'/
27
Number
Discharged
Correctly
I n con ectly
Unknown
Sump pumps
Foundation drains
1111
Roof drains
411
City of falan
Residential Sanitary Sewer Service
Compliance Inspection
Date / /Y
Name ..ri 4/tDisk #
• Qam
Time /..s
0
PID Number
House Number 9gi/C Street Name
Alternative Mailing Address
Compliance
0 No foundation drain connection
ID roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No surnp pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Pi operty Owner
Owner/OccupandSignature
NOlii-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
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time i Z
Phone
Obstruction
Unable to push past
feet
,/?inspector Signature
0 am
F‘` Pm
For information call 651.470.2788
No Access
O No one in
Enter ed S L at 37,4c46.7- Ct.')
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
( 77 ,
Sag/Pipe Deflection
Damaged Pipe
Transition L/ /1-(cf Pt,c
Viv
Final Cleanout:
Pink Copy: SEH