4620 Penkwe Way - Inspection Form4111
Cit al E;a
Residential Sanitary Sewer Service
Compliance Inspection
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Date 1 ? ▪ f 3� ?
Name
Number
Alternative Mailing Address
Time
/Disk#
a
PID Number
am
a pm
Street Name
Record Number
4 .� T (am
Time • O pm
t
Phone , - I �. ° 9 4;r
__'^..._
Owner /Occupant Signature
Inspector Signature
For information call 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
O No sump pump
Service Lateral Inspection Findings
Transition
] L 44
4" to 6" Transition:
White Copy: Property Owner
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
A
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered St, at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1
.} final Cleanout:.9� -
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Note
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Tot
Sump pumps
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Foundation drains
Roof drains
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4111
Cit al E;a
Residential Sanitary Sewer Service
Compliance Inspection
}} )
Date 1 ? ▪ f 3� ?
Name
Number
Alternative Mailing Address
Time
/Disk#
a
PID Number
am
a pm
Street Name
Record Number
4 .� T (am
Time • O pm
t
Phone , - I �. ° 9 4;r
__'^..._
Owner /Occupant Signature
Inspector Signature
For information call 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
O No sump pump
Service Lateral Inspection Findings
Transition
] L 44
4" to 6" Transition:
White Copy: Property Owner
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
A
Length of Service:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered St, at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1
.} final Cleanout:.9� -
Pink Copy: SEH