HomeMy WebLinkAboutSump Pump Inspectiono~ PRI~~P City of Prior Lake
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~ ~ Sump Pump and I/I Reduction
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rNNES°`~ Inspection Form
ANNUAL CERTIFICATION RE-INSPECTION ~
Name: ~~i~-}-I•i ~ ~Ja.i--ry Date: ~` ~ l~ Time: ~ '•'DO aml~r
Inspection: 0 First ^ Second ~C -~~~
Address: ~15 ~o ,,~,-~e,r ~ ~ Own ^ Rent ; Age; of Home:
Prior Lake, MN 55372 Phone: 1' ~~J~ (~i Residential `0 Non-Residential
A. BASEMENT ~Yes O No SUMP BASKET ^ 0 1^ 2 ^ 3 ^
WATER IN BASKET O Yes ~ No SUMP PUMP ^ U ~ 1 ^ 2 p 3 ^
WATER IN BASEMENT O Yes ~ No CISTERN D::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.)
Discharge Point p Laundry tub p Sanitary sewer ;~Outside
at Insj~ection: p Floor drain p Other
Prior ~o Inspection:
Wheri was system installed, or most recently modified? (Date) and why?
p Home came with system ^ Response to inspection program p Other
^ Water in basement ,Q~ Previous system failed
B. ROO~' LEADERS ^ Yes ^ No DISCHARGE ^ Near ^ Away
C. YARD DRAINS ~ ^ Yes `~No WINDOW WELLS ^ Yes ^ No
BEAVER SYSTEM ^ Yes ~) 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? O Front ^ Back ^ Side
NOTES:
SUMP PUMP SYSTEM: 1jS~, PASS O FAIL You hure 30 days In bri~ig your sy.~tern i~rro compliance wiih currenl
~ regidalinn.r. When yow ure reuJy jor rr-i~ispecliai, cull 9521447-9833,~nr nn nppoinlnieN.
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 so the clear water discharges to the storm sewer system.
Inspector• Date: ( ~ T ~ ~~ l
Resident:~ Date:
I Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections I
and does not imalv the structure meets all Citv Codes.
Y'~C b~`~"C C~ Ir~o.~.e-a a~ • 4-~l dIR+~/
4
A. BASEMENT ~Yes ~ No SUMP BASKET ta 0~ 1 ~ 2 ~ 3 ~
WATER IN BAS T~ Yes ~ i No 5UMP PUMP ~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes~No
(If no pump, place sticker across edge of sump cover and basement tloor so any removal of cover will
break seal. Skip to Part B of this form. )
Discharge Point ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: O Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
B.
C.
D.
NOTES:
~ Winter
~ Side
SUMP PUMP SYSTEM: ~ PASS ' ~ FAIL You have 30 days to bring your system utto compliance with current
regulations. When you are ready for reinspection, cal[ 651/644-1469 for an appointment.
Is there another place where clear water e~ters the sanitary sewer system? ~ Yes No
Where is this location? ~
This area wi~ to b~ ed so the clea~a~'e't~discharges to the storm sewer system.
Date:~lJ ~/~ -'
Date:
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.
White: Homeowner Yellow: City \ Pink: HRG
~ Home came with system L~ Response to inspection program ~ Other
O Water in basement ~ Previous system failed
ROOF LEADERS: Q YesC~ No DISCHARGE: ~ Near ~ Away
YARD DRAINS ~ Yes~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes~ No
PROPERTIES WITH SUMP PUMPS
When does pump run? L7 Fall ~ Summer ~ Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? Front O Back
-•-•-•-•-•-•-•-•-•-•-•-•-•---•---•-----•---•-•-•-•-•~-•-•-----------•-•-•-•---•---
~~ ~~'~i ~ ~`J .`: ~ ~'~
: ~:~ ~-'
f
b~- ^ ~
^
•~
~
~
(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 L~1'~,aundry tub ~ Sanitary sewer a Outside
at Inspection: O Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
C~' Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~~ DISCHARGE: Q Near Q Away
C. YARD DRAINS O Yes P~''N~o WINDOW WELLS ~ Yes ~
BEAVER SY5TEM ~ Yes I~~
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? O Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES: ~I/L Ta LaUhc~r/--T~•T•-•-•-•-•-•-•-----•-•-•-•-------•-•-•---•-•-•-•-•-•-•---•-•-----•-----•---•-•-
~~
SUMP PUMP SYSTEM: ~ PASS AIL You have 30 days to bring your system into compliance with current
regulations. When you are ready}'or reinspection, ca[[ 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: /- ..Z ? • 9 7
Date: ~ - 12 - 9 9
Disclaimer: This ' ual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG
A. BASEMENT ~ O No~~-~ SUMP BASKET ~ 0 Pl 1 Q 2 ~ 3 ~
WATER IN BASKET Q Yes ~'No SiJMP PUMP ~ 0 ~~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) D Yes ~ CISTERN ~ Yes Ci"iQ'o ~