HomeMy WebLinkAboutSump Pump Inspection
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City of Prior Lake
Sump Pump and III Reduction
Inspection Form
Name:J1;:J)J .t:.,'OlJSk ~ l1;ciJNE1- Date:.';? ~~<;:99rime:J52::)aom./pomo
Me) ,0'-
~ I- '::J, _/ , __.....,' /''/ First Inspe~n 1O'/Second 0 " / ,
Address:'~ / 7/ kC) {c, / 7 l::.l::..-lJ't.L / C' / K Ow~: ~ Rent: 0 Age of Home: /.ifc.(t 5
/7 ~// . J 1 ;; .; /' ReSIdentIal: ~ _..i
Prior Lake, MN 55 -J /p Phone:!',(,/O-"","5,5V3 Non-Residential: 0
/ I ./
,/--. UVt- /c: A.... ' / "
BASEMENT Mes 0 No SUMP BASKET 0 !),/g..'1 0 2 0 3 0
WATER IN BASKET 0 Yes ~ SUMP PUl\lpgO 0 1 0 2 03 0
WATER IN BASEMENT (flow over floor) 0 Yes o-N(; CISTERN 0 Yes 01if~
/", , ' 1_.,-'
r / /);/ /
./YI .
A.
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point
at Inspection:
o Laundry tub
o Floor drain
o Sanitary sewer 0 Outside
o Other ._-
--"~-
B.
C.
Prior to Inspection:
When was system installed, or most recently modified? (Date)
tviI~me came with system 0 Response to inspection program
o Water in basement 0 ~ious system failed
ROOF LEADERS: ~ Yes 0 N~. DISCHARGE: 0 Near 1lJ-.-~~y
,/
o Yes t(":t,rer'
o Yes B"'N 0
..
and why
o Other
.,.
\
YARD DRAINS
BEAVER SYSTEM
WINDOW WELLS
o Yes I!J..-.NO
D.
PROPERTIES WITH SUMP PUMPS
When does pump run? 0 Fall 0 Summer
(check all that apply) How often does pump run?
Where does pump discharge to outside? 0 Front
o Back
o Side
o Spring
o Winter
--
-----.-------.-------.-------------------------.---------------------------------------------------------------------.-----------.-
NOTES:
SUMP PUMP SYSTEM:
-....
~SS 0 FAIL You have 30 days to bring your system into compliance with current
regulations, When you are ready for reinspection, call 6511644-1469 for an appointment,
Is there another place where clear water enters the sanitary sewer system? 0 Yes ~c;'
Where is this location?
This area will need to ~~, ~..80 ~he c,lrJ water discharges to the storm sewer s:ste~.
Inspector: _-ri;:J.){:;>'1P-d~ Date: .2 ..,.2S- 99
Resident: , /)(it#..rI,.7/)>ji/;//I)/I// . Date: ~ - ,<;-'5 - 99
Disclaimer: This visual inspection is done with due diligence to rmd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG
,'<
4--
City of Prior Lake
Sump Pump and III Reduction
Inspection Form
Name:/1lI1N;(DWSKI
Prior Lake, MN 55
Phone:
Date:.9...;l-9'7 Time:&f<a.m.g
First Inspection ~ Second 0
Own: 'l( Rent: 0 Age of Home:
Residential: ~
Non-Residential: 0
~ ~Address3} 7115t177L.<N",""- ~I /.L
A. BASEMENT 0 Yes ~o SUMP BASKET }f. 0 LJ 1 LJ 2 LJ 3 LJ
WATER IN BASKET DYes ONo SUMP PUMP ~o 0 lOt P 3 0
WATER IN BASEMENT (flow over floor) 0 Yes ""Xl No CISTERN 0 Yes )(J"No
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point
at Inspection:
o Laundry tub
o Floor drain
o Sanitary sewer
o Other
o Outside
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
o Home came with system
o Water in basement
o Response to inspection program LJ Other
o Previous system failed
o yes)Q No DISCHARGE: 0 Near 0 Away
o Yes ~ No WINDOW WELLS 0 Yes 0 No
LJ Yesii/.: No
B.
C.
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
D. PROPERTIES WITH SUMP PUMPS
When does pump run? 0 Fall 0 Summer 0 Spring 0 Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? 0 Front 0 Back LJ Side
-~c;;:~s~._.~~~~~.~_.~~-~_._._._._._._._-_._._._._._.-.-------.-.-.-.-.-.-.-.---.-.-.-.-.-.-.-.-
SUMP PUMP SYSTEM: ~ASS 0 FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection. call 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? 0 Yes >cf No
Where is this location?
This area w~, d to)f fixed so the clear 'fat8f discharges to the storm sewer s:stem, .
Inspector~ f./f Jl'J-JI~ Date: ~--~ -79
Resident: /" Date:
Disclaimer: This visual inspection is done with due diligence to fmd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
/
White: Homeowne(
Yellow: City
Pink: HRG
: