4674 Penkwe Way - Inspection FormCity of fa ao
Residential Sanitary Sewer Service
Compliance Inspection
Date /1
jj
lfi'!I
Name ` ) )
PID Number
House Number 2 -4 - r Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 65 I A70.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump. pit not connected to
sanitary sewer
q Sump pump properly piped
0 No sump pump
Disk #W
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Phone /! - . , r- /1
�' am
Time • 1 pm
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
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
0 am
•
Time • o p
Obstruction
Unable to push past
feet•
In Signature ) ?) }1 f d
�p�` l r'O
Entered S L. at
Final Cleanout
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump urn s
/1
Foundation drains
. _. • -°
"
Roof drains
City of fa ao
Residential Sanitary Sewer Service
Compliance Inspection
Date /1
jj
lfi'!I
Name ` ) )
PID Number
House Number 2 -4 - r Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 65 I A70.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump. pit not connected to
sanitary sewer
q Sump pump properly piped
0 No sump pump
Disk #W
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Phone /! - . , r- /1
�' am
Time • 1 pm
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
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
0 am
•
Time • o p
Obstruction
Unable to push past
feet•
In Signature ) ?) }1 f d
�p�` l r'O
Entered S L. at
Final Cleanout
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH