4604 Penkwe Way - Inspection Form441110. City of Calif]
a
Residential Sanitary Sewer Service
Compliance Inspection
Date__ LIL/ f
Name
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
No roof drain connection
Sump pit not connected to
sanitary sewer
White Copy: Property Owner
OwnerlOccupant Signature
Disk #
Street Name
a
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition x. j_ _ ! r P
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
Yellow Copy: City of Eagan
fJ
Record Number
Time
Phone — 7; 7"---)
Inspector Signature
-2( qqpp// am
• �t� pm
Entered S.L at
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:,
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
f ` ,
�j
Total
Sump pumps
Foundation drains
Roof drains
ME-
IM
441110. City of Calif]
a
Residential Sanitary Sewer Service
Compliance Inspection
Date__ LIL/ f
Name
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
No roof drain connection
Sump pit not connected to
sanitary sewer
White Copy: Property Owner
OwnerlOccupant Signature
Disk #
Street Name
a
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition x. j_ _ ! r P
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
Yellow Copy: City of Eagan
fJ
Record Number
Time
Phone — 7; 7"---)
Inspector Signature
-2( qqpp// am
• �t� pm
Entered S.L at
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:,
Pink Copy: SEH