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HomeMy WebLinkAboutSump Pump Inspection City of Prior Lake Sump Pump and III Reduction Inspection Form ANNUAL CERTIFICATION RE-INSPECTION 2002 Name: ~\Lb\N~\ Address: ~2 \ lA;\}lillE.. A'JE- Prior Lake, MN 55372 Phone: 44-0- Sl.tlk Date:~ Time: q..ooamp Inspection: 0 Second )!( Third li Own 0 Rent }S Residential Age of Home: o Non-Residential A. BASEMENT JlYes 0 No SUMP BASKET DO XlI 02 0 3 0_ WATER IN BASKET DYes t2!'-No SUMP PUMP OO)g1I 02 0 3 0_ WATERINBASEMENT 0 Yes JitNo CISTERN 0 Yes Ji{No (If no pump, place sticker across edge of sump cover and basement floor so any removal of cover wiIl break seal. Skip to Part B.) Discharge Point at Inspection: o Laundry tub o Floor drain o Sanitary sewer o Other )8n Outside Prior to Inspection: . ' l When was system installed, or most recently modified? (Date) \1/ qq and why? . 0 Home came with system 0 Response to inspection program 0 Water in basement ,. Previous system railed 0 Other ! B. ROOF LEADERS 0 Yes )dNo DISCHARGE 0 Near OAway C. YARD DRAINS 0 Yes IS1 No WINDOW WELLS 0 Yes )(No BEAVER SYSTEM., 0 Yes ~No D. PROPERTIES WITH SUMP PUMPS When does pump run? " Fall "Summer" Sprlni 0 Winter (check all that apply) How often does pump run? Vent, Of-+ev\ au.( t~ V'QIY"\ s.~r'lAS Where does pump discharge to outside? 0 Front ,.Back 0 Side ~ .............................................................................................................................................................................................................................................................................................................................................................................-............. NOTES: SUMP PUMP SYSTEM: 7' PASS o FAIL You have 30 days to bring your system into compliance with current regulations. Please caI/9521447 .9833 for a re-inspection appointment. Is there another place where clear water enters the sanitary sewer system? Where is this location? This area will need to be fixed so the clear water discharges to the storm sewer system. DYes )i(No I IDspecro'{)l~ ReSIdent: Date: ~ 01- Date: Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections and does not im I the structure meets all Cit Codes. ~I~ U:,~y VlIHLJ3D 3{ICt (0 2- . " .. City of Prior Lake Sump Pump and III Reduction Inspection .form Name: \ 1.L,<:(A\Lo t~ Date: \ 1/ :Y1-'1QTime: l35a.m.8 Address: \\oql\ ~~~,~~S~ ~~~:~:~:g ~;~~'t:me:4- (' 0'- Residential:.e' Prior Lake, MN 55 7; 11- Phone: \\~~ - jb ~ Non-Residenti~l: 0 A. BASEMENT a:Y es 0 No SUMP BASKET 0 0 ~ 1 0 2 0 3 0 WATER IN BASKET ~es 0 No SUMP PUMP 0 0 lV1 0 ~ 9 3 0 WATER IN BASEMENT (flow over floor) 0 Yes ~No CISTERN 0 Yes ..Q{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 )("" Outside o Sanitary sewer o Other \ 'L- \c-\\ B. C. Prior to Inspection: When was system installed, or most recently modified? (Date) o Home came with system )S( Response to inspection program ~ Other o Water in basement 0 Previous system failed ROOF LEADERS: )J:Yes 0 No DISCHARGE: 0 Near ~ Away YARD DRAINS 0 Yes~...No WINDOW WELLS 0 Yes)(No BEAVER SYSTEM 0 Yes 12' No and why D. PROPERTIES WITH SUMP PUMPS When does pump run? 0 Fall l( Summer (check all that apply) How often does pump run? Where does pump discharge to outside? 0 Front o Side ~Pring ~ack o Winter ---.-.---.-.-------------.-----------------.-----.-------.-----.-------------------.-------------------------.-------.-.----------- NOTES: SUMP PUMP SYSTEM: o 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. JfNO PASS Is there another place where clear water enters the sanitary sewer system? Where is this location? This area will neecl DYes Inspector: Resident: Date: Date: Disclaimer: visual inspection is done with due diligence to fmd obvious clear water cross-connections and does not im I the structure meets all Cit Codes. White: Homeowner Yellow: City Pink: HRG . \I'::"~ ,,~ .,:. ; .r '~;'J." City of Prior Lake Sump Pump and III Reduction Inspection Form Name: K(~ kOwsk,' I 0tllV'\'1F,j D"'VJ4 Date: 7- 2- 7, '71 Time: tJr 1.5" a.m.lp.m. Prior Lake, MN 55.J 7...;L. Phone: '-;"/0 -;-666 First Inspection ~Second 0 Own: ~Rent: 0 Age of Home:-2S:yr.:. Residential: ~ Non-Residential: 0 Address: It r Z I DI"'~'t+t ~ .A f. .: r.J A. BASEMENT ~ LJ No SUMP BASKET LJ 0 a'1 LJ 2 LJ 3 LJ WATER IN BASKET ~s LJNo SUMPPUMP. LJ 0 cr"""lLJ 2 LJ 3 LJ WATER IN BASEMENT (flow over floor) LJ Yes I3"NO CISTERN LJ Yes ~ (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 ~ry tub at Inspection: LJ Floor drain LJ Sanitary sewer LJ Other LJ Outside Prior to Inspection: When was system installed, or most recently modified? (Date) ~me came with system LJ Response to inspection program .(r,,,..cc't2J>'Water in basement LJ Previous system failed ~.l B.' ROOF LEADERS: LJ Yes ~ C. YARD DRAINS LJ Yes ~ BEAVER SYSTEM LJ Yes 9--No and why LJ Other DISCHARGE: LJ Near LJ Away WINDOW WELLS ~ LJ No D. PROPERTIES WITH SUMP PUMPS When does pump run? LJ Fall LJ Summer LJ Spring (check all that apply) How often does pump run? ;:;<1 "'~.. f It' ;'" Where does pump discharge to outside? LJ Front ' LJ Back LJ Winter J/,,., J................., , LJ Side &,1' I... v' Rv;1-11 NOTES: LJ PASS ~ 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 Y es ~ Where is this location? This area will need to be fixed so the clear water discharges to the storm sewer system. I =::: 1J;;~~ZhoL . ~::: ~-- ~~~ ;: Disclaimer: This visual inspection is done with due diligence to f"md obvious clear water cross-connections and does not im I the structure meets all Cit Codes. SUMP PUMP SYSTEM: White: Homeowner Yellow: City Pink: HRG