4690 Penkwe Way - Inspection Formtit of F a
Y �
Residential Sanitary Sewer Service
Compliance Inspection
/
Date
Name—
Alternative Mailing Address
Owner /Occupant Si gnature
Compliance
O No foundation drain connection
I
t No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Time
s k #
• (J am
• pm
LL-
P1D Number
House Number T %f'i >' .( Street Name
Phone
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Record Number i �r
■
Time
Inspector Signature
Obstruction
Unable to push past
feet
Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
p am
•
• 0 Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
i "�f r _
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
-) .. /
' j
�1 ' 57"--;
Foundation drains
Roof drains
a)
tit of F a
Y �
Residential Sanitary Sewer Service
Compliance Inspection
/
Date
Name—
Alternative Mailing Address
Owner /Occupant Si gnature
Compliance
O No foundation drain connection
I
t No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Time
s k #
• (J am
• pm
LL-
P1D Number
House Number T %f'i >' .( Street Name
Phone
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Record Number i �r
■
Time
Inspector Signature
Obstruction
Unable to push past
feet
Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
p am
•
• 0 Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH