4637 1_2 Penkwe Way - Inspection FormCity or hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 .a1f '
Name ') L --f //
PID Number
House Number
Alternative Mailing Address
For information call 65 1.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
9Y Sump pump properly piped
O No sump pump
Sag /Pipe Deflection
Damaged Pipe
Transitio
r
4" to 6" Transition:
White Copy: Property Owner
! treet Name
OwnerlOccupant Signature
t ` 4, (J am
Time v
JL ✓ pm
Disk At
Non - Compliance
Record Number
} ,'2e -
Time f L / o
Phone , :r� - 2— —. L k i i
Obstruction
Inspector Signature
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S. L at r -✓-'ice ?� r�
Roots
Poor Pipe Joints
Mineral Deposits
Yellow Copy: City of Eagan
J 1
Final Cleanout: 1 ,7 — J
c,am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Note
,f / �
_
/y ��
' f
/ � ' }
r
4,...::„........„.2
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
drains
IIIII Foundation
Roof drains
f�
City or hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 .a1f '
Name ') L --f //
PID Number
House Number
Alternative Mailing Address
For information call 65 1.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
9Y Sump pump properly piped
O No sump pump
Sag /Pipe Deflection
Damaged Pipe
Transitio
r
4" to 6" Transition:
White Copy: Property Owner
! treet Name
OwnerlOccupant Signature
t ` 4, (J am
Time v
JL ✓ pm
Disk At
Non - Compliance
Record Number
} ,'2e -
Time f L / o
Phone , :r� - 2— —. L k i i
Obstruction
Inspector Signature
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S. L at r -✓-'ice ?� r�
Roots
Poor Pipe Joints
Mineral Deposits
Yellow Copy: City of Eagan
J 1
Final Cleanout: 1 ,7 — J
c,am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH