4757 Penkwe Cir - Inspection Form4 1. Cll of Fla p°
Y � °
Residential Sanitary Sewer Service
Compliance Inspection
Date )t
f
Name !! .
PID Number
House Number . - Z .) , Street Name i ) ro
Alternative Mailing Address
For information call 651.470.2788
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
Service Lateral Inspection Findings
Roots
Poor Pipe Joints ! L .
Mineral Deposits ; 1 z
SaglPipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
`1'
White Copy: Property Owner
Time f' a
Disk # f
Owner /Occupant Signature
f✓ Q am
• O pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanr ry
sewer
Flexible s(imp pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number / t
Time
Phone
Obstruction
Unable to push past
feet,
Final Cleanout:
• am
o pm
Inspector Signature J
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S,L.at
/
Pink Copy: SEH
Number Discharged
Un known
Notes
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Total
Correctly
Y
Incorrect! Y
Sump pumps
,�r
,
Foundation drains
Roof drains
\ i
4 1. Cll of Fla p°
Y � °
Residential Sanitary Sewer Service
Compliance Inspection
Date )t
f
Name !! .
PID Number
House Number . - Z .) , Street Name i ) ro
Alternative Mailing Address
For information call 651.470.2788
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
Service Lateral Inspection Findings
Roots
Poor Pipe Joints ! L .
Mineral Deposits ; 1 z
SaglPipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
`1'
White Copy: Property Owner
Time f' a
Disk # f
Owner /Occupant Signature
f✓ Q am
• O pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanr ry
sewer
Flexible s(imp pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number / t
Time
Phone
Obstruction
Unable to push past
feet,
Final Cleanout:
• am
o pm
Inspector Signature J
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S,L.at
/
Pink Copy: SEH