4664 Penkwe Way - Inspection FormSum pumps
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Foundation drains
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Roof drains
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City 1' Papa
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Residential Sanitary Sewer Service
Compliance Inspection
Date // /
House Number _, Street Name
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
4" to b" Transition:
f - 1
f
Owner Signature
White Copy: Proper Owner
Time
J 11 U am
, 211(,:e) /
1 ' pm
Name . / "7 Disk # -� [-
PID Number 1
Number Discharged
Total Correctly Incorrectly
J
Unknown
m
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
Obstruction
Unable to push past
feet
Length of Service: Final Cleanout:
j
C_ c'
Time
Inspector Signature
)
o am
•
• O pm
Alternative Mailing Address Phone ° ? .
For information call 651.470.2788
Notes
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH