4602 Penkwe Way - Inspection FormSump pumps
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Foundation drains
Roof drains
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City Of: haafan
Residential Sanitary Sewer Service
Compliance Inspection
Date / 7 / ) f Time
Name f ✓, ) Disk #
PID Number
House Number
Alternative Mailing Address
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
V. Street Name
OwnerlOccupant Signature
Compliance
O 0 No foundation drain connection
Service Lateral Inspection Findings
Total
Correctly
am
Pm
Roots
Poor Pipef oints
Mineral Deposits
Sag /Pipe Deflection .d )
Damaged Pipe � �i j l ° ) , 1.1 i t 2< ..
Transition
Lei ,m ica )
Number Discharged
Incorrectly Unknown
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
Record Number
Time it , ` % • o pm
Phone
lnspec Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
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` f Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks j Entered S L at
n 1 I
Notes
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Yellow Copy: City of Eagan Pink Copy: SEH