4695 Penkwe Way - Inspection Form4111
'
City of to ail
Residential Sanitary Sewer Service
Compliance Inspection
1 4 j / . .)
Date /( i1 c / /I Time
Name � J (� )i� Disfc #
PID Number
House Number ! ." Street Name
(11
•
OwnerlOccupant Signature
am
Pm
-LL]
Record Number.
A
Time
o am
•
• o pm
' L._ ✓?
Alternative Mailing Address Phone
Inspector Signature
For information call 651.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump.pump
Service Lateral inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
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 of stacks
Obstruction
Unable to push past
feet.
Entered S.L,at
Roots
Poor Pipe Joints
Mineral Deposits,
Sag /Pipe Deflection_
Damaged Pipe
Transition
Length of Service:
Notes
Final Cleanout:
•-r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
/ �
` �
,
0
Foundation drains
Roof drains'
4111
'
City of to ail
Residential Sanitary Sewer Service
Compliance Inspection
1 4 j / . .)
Date /( i1 c / /I Time
Name � J (� )i� Disfc #
PID Number
House Number ! ." Street Name
(11
•
OwnerlOccupant Signature
am
Pm
-LL]
Record Number.
A
Time
o am
•
• o pm
' L._ ✓?
Alternative Mailing Address Phone
Inspector Signature
For information call 651.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump.pump
Service Lateral inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
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 of stacks
Obstruction
Unable to push past
feet.
Entered S.L,at
Roots
Poor Pipe Joints
Mineral Deposits,
Sag /Pipe Deflection_
Damaged Pipe
Transition
Length of Service:
Notes
Final Cleanout:
•-r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH