4621 1_2 Penkwe Way - Inspection FormSump pumps
t r'/
.
Foundation drains
Roof drains
el. City of Flap
Residential Sanitary Sewer Service
Compliance Inspection
Date /1 Time
Name Me » d/ / }_
Disk #
PID Number /
House Number 1 _ -, , J/ Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651 .470.2788
Compliance
O No foundation drain connection
A
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
()Vs
l ? r f� f l
Transition
4" to 6" Transition:
3
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
Number of stacks -1
Number Discharged
Total Correctly Incorrectly Unknown
White Copy: Property Owner
Record Number
Time
J j • .j� oam
-• _ pm
Phone
Obstruction
Unable to push past
feet
Entered S at
inspector Signature
{
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanou . .�
Notes
Yellow Copy: City of Eagan - r Pink Copy: SEH