4645 1_2 Penkwe Way - Inspection Form411110' City oI' Evan
Residential Sanitary Sewer Service
Compliance Inspection
Date - -_ L /
-` ' /rl `� / . --
Name _c Disk #
s
s
Imes -' � F 0 pm
UOwner /Occupant Signature
PID Number
House Number - - `Street Name
r*-a
Alternative Mailing Address
tl
J
Record Number
Phone
�': sue-
Time �i e .
1
Inspector ignature
am
0 pm
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
Non- Compliance
O
O
O
O
0
Service Lateral Inspection Findings
Boots
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Sag /Pipe Deflection
Damaged Pipe
Transition
- y La ' j 7 f - - 1 --.17
Number of stacks Entered S. L at
Length of Service:
Yellow Copy: City of Eagan
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
•
t f
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes _
/ 7 / ; / .�..� :!,, -r l : =/ : f ' :. -:..' � ,.
_,
�'�'� I'
,
Total
Sump pumps
fin' r ;1 � )c/f)r�
- ---)
Foundation drains
o f ) iimi
r
Roof drains
`l -
, 1
;
11111
411110' City oI' Evan
Residential Sanitary Sewer Service
Compliance Inspection
Date - -_ L /
-` ' /rl `� / . --
Name _c Disk #
s
s
Imes -' � F 0 pm
UOwner /Occupant Signature
PID Number
House Number - - `Street Name
r*-a
Alternative Mailing Address
tl
J
Record Number
Phone
�': sue-
Time �i e .
1
Inspector ignature
am
0 pm
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor Pipe Joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
Non- Compliance
O
O
O
O
0
Service Lateral Inspection Findings
Boots
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Sag /Pipe Deflection
Damaged Pipe
Transition
- y La ' j 7 f - - 1 --.17
Number of stacks Entered S. L at
Length of Service:
Yellow Copy: City of Eagan
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
•
t f
Final Cleanout:
Pink Copy: SEH