4648 1_2 Penkwe Way - Inspection FormCity llf EaR,aa
Residential Sanitary ,Sewer Service
Compliance inspection
r'1
Date a 1 f i( : i
Name
PID Number
j /�
House Number �1�1 l-- �5treet Name
Alternative Mailing Address
Roots
l
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 . Number of stacks f Entered S.L.at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
749d ' O a m
Time �7 • pm
Disc #
Owner/Occupant Signature
f, 7)
.14
)
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
f3�
Yellow Copy: City of Eagan
Record Number
Time
Phone
•
•
Inspector Signature
Obstruction
Unable to push past
feet.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
p
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7 =: -e'
rr / Final Cleanout: ) . .. L--
Pink Copy: SEH
N
Correctly
Discharged
Incorrectly Unknown
Noes
/
, f `ic ��3��
J
' 1
I
Total
Sump pumps
, �!
( /
- �) ,,
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J
Foundation drains
�
Roof drains
/ j '
City llf EaR,aa
Residential Sanitary ,Sewer Service
Compliance inspection
r'1
Date a 1 f i( : i
Name
PID Number
j /�
House Number �1�1 l-- �5treet Name
Alternative Mailing Address
Roots
l
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 . Number of stacks f Entered S.L.at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
749d ' O a m
Time �7 • pm
Disc #
Owner/Occupant Signature
f, 7)
.14
)
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
f3�
Yellow Copy: City of Eagan
Record Number
Time
Phone
•
•
Inspector Signature
Obstruction
Unable to push past
feet.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
p
c � _ .,..�
. ff .. 1,__._ -! C�r R L.
A >S
I .`1-- --1-.- c.. -•i c.°-" " "fie- 4 ` :�9 A " - - -fr4 ." ° r �
,
--
7 =: -e'
rr / Final Cleanout: ) . .. L--
Pink Copy: SEH