4772 Penkwe Cir - Inspection Formatfr
City of Elan
Residential Sanitary Sewer Service
Compliance Inspection
Date it 1 r
1
Name 5 -1`` - r °°° ' � g 'y' Disk #
PlD Number
House Number'- ,. Street Name
Alternative Mailing Address
' s -
Owner /Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit riot connected to
sanitary sewer
— i
Sump pump properly piped
'O No sump pump
p+' am
Time " pm
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
Roots -
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection___
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Record Number
Notes
Time
;,4 j.
Phone si
L
Obstruction
Linable to push past
feet
c--
o am
•
• o pm
inspector Signature
For information call 651.470.2788
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L. at
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
4
r
Foundation drains
Roof drains
-)
atfr
City of Elan
Residential Sanitary Sewer Service
Compliance Inspection
Date it 1 r
1
Name 5 -1`` - r °°° ' � g 'y' Disk #
PlD Number
House Number'- ,. Street Name
Alternative Mailing Address
' s -
Owner /Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit riot connected to
sanitary sewer
— i
Sump pump properly piped
'O No sump pump
p+' am
Time " pm
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
Roots -
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection___
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Record Number
Notes
Time
;,4 j.
Phone si
L
Obstruction
Linable to push past
feet
c--
o am
•
• o pm
inspector Signature
For information call 651.470.2788
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L. at
Pink Copy: SEH