4635 Penkwe Way - Inspection FormSump pumps
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Foundation drains
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Roof drains
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4. City of ha an
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number
Alternative Mailing Address
/t)) _ Disk #
Sump ump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Piopeity Owner
Time j' 0 am
pm
1 i - k Street Name
1
Compliance
O No foundation drain connection
No roof drain connection
I
OwnerlOccupant Signature
Service Lateral Inspection Findings
Number of stacks
ual-o3 a
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 Discharged
Total Correctly incorrectly Unknown
Record Number
Notes
• Sc-, 0 am
Time • pm
Phone ) - 41_
Inspector Signature
Obstruction
Unable to push past
feet
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L.at
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition I-4-- r - )fr
4" to 6 "Transition: ..Ledge f e ?t l Cl
Finaeanout: �
7
/1) 1? 3
Yellow Copy: City of Eagan Pink Copy: SEH