4608 1_2 Penkwe Way - Inspection Form4 • of Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date a / t
Name i , • Disk #
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
Service Lateral Inspection Findings
4" to 6 "Transition: ( ,f' ".,
White Copy: Property Owner
0am
Time • o pm
PID Number
i
House Number treet Name
Alternative Mailing Address
1 i'• /\/ �` 7
A i \ f �. \
OvnerlOccupant Signature
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
Number of stacks
Phone � _� �`� ; >
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1�
Transition
e h f,Servrce' - ;
Yellow Copy: City of Eagan
Record Number
Time r
Obstruction
Unable to push past
feet
•
•
Inspector Signature
Final Cleanout:
1)
O am
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L,at`°r
Pink Copy: SEH
Total
Notes
-' ye � � � /'`
' _� / 1 /� , � -. �~ }
7 1 S' .6 -1 7 4 --'rf ' 7C� '" /etr
/) ( .—,e_
1 r i, l ii . c_ /-'';: - 0H - 9
�/2' / 1, 7 C ---. ) ---
Number
Discharged
Correctly
Incorrectly
U
Unknown
Sump pumps
._
,Z--
/' r
: IS_.f , / ) e
7 `� ?
/'L .7
1 1
2,
2
Foundation drains
Roof drains
4 • of Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date a / t
Name i , • Disk #
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
Service Lateral Inspection Findings
4" to 6 "Transition: ( ,f' ".,
White Copy: Property Owner
0am
Time • o pm
PID Number
i
House Number treet Name
Alternative Mailing Address
1 i'• /\/ �` 7
A i \ f �. \
OvnerlOccupant Signature
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
Number of stacks
Phone � _� �`� ; >
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1�
Transition
e h f,Servrce' - ;
Yellow Copy: City of Eagan
Record Number
Time r
Obstruction
Unable to push past
feet
•
•
Inspector Signature
Final Cleanout:
1)
O am
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L,at`°r
Pink Copy: SEH