4758 Penkwe Cir - Inspection Form*PA.
City 00 Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date I.. 2 5 )7?
Name / _ k #
PID Number
House Number reet Name
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
• 9 am
Time • pm
m -m
1
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Number of stacks Entered S Lat
Phone I _.. `7 �L7
Obstruction
Unable to push past
feet.
Inspector Signature
For information call 651.470.2788
Roots
Poor Pipe Joints_
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
• Q am
• Q pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
f ��
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
Foundation drains
-
Roof drains
*PA.
City 00 Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date I.. 2 5 )7?
Name / _ k #
PID Number
House Number reet Name
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
• 9 am
Time • pm
m -m
1
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Number of stacks Entered S Lat
Phone I _.. `7 �L7
Obstruction
Unable to push past
feet.
Inspector Signature
For information call 651.470.2788
Roots
Poor Pipe Joints_
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
• Q am
• Q pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
f ��