4670 Penkwe Way - Inspection FormSump pumps
Foundation drains
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Root drains
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Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
/
PID Number
House Number
Alternative Mailing Address
OwnerlOccupant Signature
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
4" to 6" Transition:
White Copy: Proper ty Owner
: r 1 Disk #
) )73 ;I
•'; / 9 am
Time • O pm
Street Name 1�✓� �'. "� A
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 Ser vice:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Time
Phone , 1
For information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks Entered S L at
Inspector Signature
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
Final Cleanout:
O am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
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