4722 Penkwe Cir - Inspection FormSump pumps
Foundation drains
Roof drains
" ._
4. 111. Residential Sanitary Sewer Service
City of Cap Compliance Inspection
Date '' 7)1 If '
Name 7 .v"- ( \/ %Disk # L
PID Number
House Number ,�',`. f Street Name
Alternative Mailing Address
1
Owner /Occupant Signature
4" to 6" Transition:
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
Total
Time / i
am
0 pm
Number Discharged
Correctly Incorrectly
LU-LU ri Time
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
O am
•
• O pm
Phone Z)
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered Si. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: Final Cleanout:
Unknown
Notes
`
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH