HomeMy WebLinkAboutSump Pump Inspectiont'
,~~~ PRj~~'~, City of Prior Lake
~ ~
~ ~ Sump Pump and I/I Reduction
~
INNES°`` Inspection Form
~ ~
Name: ~ 'r t~ Date: ~, • ~ ~ - ~ ~ Time: ' ~ G am~
Inspection: ~First ^ Second
Address: ~(~ ~__" 1.,11~,,t i~1~ ~_ j~ Own ^ Rent Age of Home: ~
', Prior Lake, MN 55372 Phone: - ,~~ Residential ~ Non-Residential
A. BASEMENT `. ^ Yes ~No SUMP BASKET ~0 p 1 p 2 ^ 3 ^
WATER IN BASKET ^ Yes ^ No SUMP PUMP 0 p 1 ^ 2 p 3 ^
WATER IN BASEMENT ^ Yes ^ No CISTERN O Yes ~'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 J
Discharge Point ;~ p Laundry tub ^ Sanitary sewer ^ Outside
at Inspection: '' ^ Floor drain ^ Other
Prior to Inspectio~:
When was syster~ installed, or most recently modified? (Date) and why?
^ Home cam~ with system p Response to inspection program p Other
^ Water in basement p Previous system failed '~
B. ROOF LEADERS p Yes ~No DISCHARGE p Near p Away
C. YARD DRAINS` ^ Yes ~ No WINDOW WELLS p Yes ~No
BEAVER SYS'~EM p Yes ~f;No
D. PROPERTIES WITH SUMP PUMPS _
When does pump run? ^ Fall O Summer ^ Spring ^ Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ^ Front ^ Back O Side
NOTES:
SUMP PUMP SYSTEM; ~I, PASS O FAIL Yorr hare 30 days ~o hring yoursyslem i~un coi~~plinnce wi~h carrenl
regrdaliaas. Whe~r yoa are ready fi~r re-iira/~ecliar, caU 952/447-9833. j~r n~r uppoinnuem.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ,~No
Where is this location? : -
This area will need to be fixed sb the clear water dischazges to the storm sewer system.
Inspector. 'L`1~~~'~-`~> D .~` ~1J =~I :
Resident: ~ ~ (~ ate: ~~` ~C~' ~(
I Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections I
and does not implv the structure meets all Citv Codes.
r--~~'lecl ~¢py ~ ~es~~c~f 7 ~9~ a~
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: l~'x?~ ' ~~F~cc ~+~ U~~~`~""
Address: ~~ ~ 6rGr h W O~ ~f ~ N~
Prior Lake, MN 55 ~~. Phone: ~ Q' ~
A. BASEMENT ~ Y ~ No
WATER IN BASKET Yes ~ No
WATER IN BASEMEN ~~flow over floor)
(If no pump, place sticker acr s edge o um~
break seal. Skip to Part B of thi form.)
Discharge Point I~ undry
at Inspection: L~ F o ain
Prior to Inspection:
When was system installed, or most ec n
O Home ca with system R sponse i
Q Water in b sement ~r 'ous sy
~,\
,.
B. ROOF LEAD RS: ~ es ~ No
C. YARD DRAIN Yes I~ No
BEAVER SY51~EM Yes D No
Date: l2-~O~-`~9 '
` First Inspection
O~ ~ Re : ~
D,..,. e..t:..l.
Non-I~skdi`ential: ~
/p.m.
Second CIh
Age of Home:
SUMP T C~~ ~ 1 L~ 2~ 3 ~
SiJMP 0~ 1 ~ 2 Q 3 ~
Yes ~o RN ~ Yes ~ No
/
~~r an basement floor so any removal of cover will
~,
~ ~ Sanitary sewer ~ Outside
~ Other
>dified? (Date) and why
inspection program Q Other
tem failed
DISCHARGE: Q Near Q Away
WINDOW WELLS ~ Yes ~ No
D. PROPERTIES SUMP PUMPS
When does pump n? ~ Fall ~ Summe ~ Spring
(check all that ap ) How often does pump run?
V~here does p p' e to outside? ~ Front ~ Back
NOTES: ~- . -•-•-•-•- •---•----- -- C ~ ~ - ~ ~~ '- -~-•-•---•- \---•-•--
_ ~ ~\a ~~~~~ C_~~ ~;~ ~ ~
SUMP PUMP~SYSTEM: ~ PASS ~ FAIL You have 30 days to bring u~
~/ regulations. When you are ready for reinspection,~
Is there anc~her place where clear water enters the sanitary sewer system? ^
Where is ~his location?
This area~ will need to be fixed~so the clear water discharges to the storm sewer sy
Inspector: Date: _
Resident: Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water oss-connections
and does not im 1 the structure meets all Cit Codes. -- -~--
~~, ~ (1 C% ,~
~~r
White: Homeowner Yellow: City Pink: HRG
u ~~ae
n ~~e.. Sc`~ ~Lf~{~ - ~4(~~/~~ ~
I
system into compliance with current
11657 /644-1469, for an appointment.
~Yes ~ No
Q Winter
•
~
~I
)
A. BAS~MENT ~ Yes ~ No S'[TMP BASKE'i' d'0 ~ 1 ~1 2 D 3 D
W A' Y' E R I N B ASKET Q Yes ~ No SUMP PYJNII' ~ Q 0 ~ 1 t7 2~ 3 ~
W A T E R II~ T B A S E M E N T ( flow over floor) ~ Yes ~ No CISTE R N O Yes O N o
(If n~: pump, place sticker across edge of sump cover and basement floor so any remova~ of covex will
break seal. Skip to Part B of this form.)
Y7iscl~arge Point ~ Laundry wb ~ Sani~ary sewer ~'1 Outside
at Inspection: d Floor drain O Other
^}Prio: to Inspection: ~ ~ and why ~
When was syscem installed, or most recently modified7 (Date)
~~tome came with system Q Response to inspection program ,~ d Other
Q~~l/~ter i~ basement 17 Previous system failed
~3. ItOUF ~.EAD~RS: ~ Yes C3"No nISCI~ARGE: t~ Near ~ Avvay
C. YA1ZD DRAYNS O Yes ~ No vVYNDOW WEL~.S t} 'Yes ~ No
BEA~.y'ER SY5TEIVS D Yes C! No ,
D. PRUPERTIES V'VITH SYJMP PUMPS
When does pump run? ~ Fall O 5ummer ~ Spring ~ Winter
(theck all that apply) How often does pump run?
~ Back d Side
V~h~re daes pump discharge to outside? O Front -----Y•- ------•-•^ _._._...------•-•--------~------
NOTES:._ .t'~.~ ~-----• h~~ r----•-•- --~-•-•- -~--- ~G" ~ o v~.
- , ~
SUMP PU1~+tP SY5TEM: d PA5S D FAIL Yn~t hove 30 day6 ~o biixg your Sys~em 'uttu tomplia-~ce WIJh e-w/~nr
' ~egrt[atiuns. When you 4re rcudy fnr rai~u'pecfinrt. [bll 6511644-1L69 far a~t eppo
Is tt~ere anc~~er place where clear water enters the sanitary sewer system? -~ Yes Q No
Where is t,~is° location? '
This area v~.~il~ n o be fixed so the clear water discharges ta the storm sewer system.
'7 _ 9 9
Inspector~.
Resident:
~. bate: 1
, , ~ bate: 7- _ 2
DisGjaimer; This `risusl inspection is done wi~~~~ diligence
and does not imQly the strutture mtets all City Codes.
Whitc:. ~lnm4wwner Yellow: City
find obvious cle~r water cross-connections
pink; fYRG
TOTAL P.02
JUL-07-1999 09~11 HR GREEN C0. e~l b44 ~347 r.n~i~~
A. BASEMENT ~Q Yes ~ No SiJMP BASKET O 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ No 5iJMP PUMP ~ 0~ 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~. No CI5TERN ~ Yes ~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 ~ Laundry tub ~ Sanitary sewer 1f~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
17 Home came with system ~ Response to inspection program ~ Other
17 Water in basement Q Previous system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes ~ No WINDOW WELLS Q Yes ~ No
BEAVER SYSTEM ~ Yes i~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer O Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS ^ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca11651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? O Yes 17 No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~`` Date: n, 2 O
Resident: Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG