4702 Penkwe Way - Inspection FormSump pumps
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Foundation drains
Roof drains
4 1111 ) 1. City of Capp
Residential Sanitary Sewer Service
Compliance Inspection
Date f 1 � ° 1 A-0
Name / re,/
Alternative Mailing Address
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: Property Owner
• 62 am
- Time • 'o pm
Disk #
PID Number
House Number /fj �Street Name
Owner /Occupont Signature
Non - Compliance
ru-
Number of stacks
•
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:
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
Time
Obstruction
Unable to push past
feet
•
W2
o
O pm
Phone w • Z.)
Inspector Signature
For information call 651.470.2788
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L:.at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
/ I�
�
1
Yellow Copy: City of Eagan Pink Copy: SEH