Loading...
HomeMy WebLinkAboutSump Pump Inspection 5'ee City of Prior Lake Sump Pump and III Reduction Inspection Form Name: <' fJ A c t:= _ ---- - Date:~J-7q Time: a.m./p.m. Prior Lake, MN 55 Phone: First Inspection S- Own: ~ Rent: 0 Residential: .!St Non-Residential: 0 Second 0 Age of Rome: Address:/~tf1'-1 EA&I..E.. C.2UK f)v.c. 5 C A. BASEMENT 0 Yes :<<l. No SUMP BASKET ~ 0 0 1 0 2 0 3 0 WATER IN BASKET 0 Yes 0 No SUMP PUMP '" 0 0 1 0 2 0 3 0 WATER IN BASEMENT (flow over floor) 0 Yes JO No CISTERN 0 Yes 0 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 0 Response to inspection program 0 Other o Water in basement 0 Previous system failed B. ROOF LEADERS: 0 Yes ~ No DISCHARGE: 0 Near 0 Away C. YARD DRAINS 0 Yes r!J No WINDOW WELLS 0 Yes 0 No BEAVER SYSTEM 0 Y es~ No D. PROPERll~S 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 0 Side -;O;ES:;::~q;O~!~~::.:~~~~~~~:::~-~~:3t.~;t~;~.~~_._+he SUMP PUMP SYSTEM: J9... PASS 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? Where is this location? This area w~d toX fixed so th~ clear Inspector~ -.A' f I ' Resident: .. DYes ~No r discharges to the storm sewer system. Date: q...,;z / - e; 9 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: Homeowner Yellow: City Pink: HRG City of Prior Lake Sump Pump and III Reduction Inspection Form ANNUAL CERulflCATION RE-INSPECTION 2002 Name: KA-rHY ?RACE. Address: MdY14- ~ ~ME. Prior Lake, MN 55372 Phone: L-t4-1- 5'225 Date: 6 /q /62- Time: I: 10 lIMIpm Inspection: D Second )( Third ~ Own D Rent ~ Residential Age of Home: ?-J.,. Yes, D Non-Residential A. BASEMENT ~ Yes 0 No SUMP BASKET 0 0 lzi 1 0 2 0 3 D WATER IN BASKET DYes iJNo SUMP PUMP DO kJl D 2 030 WATERINBASEMENT DYes BlNo CISTERN DYes ~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 at Inspection: o LaundrY tub o Floor drain o Sanitary sewer o Other ~Outside Prior to Inspection: When was system installed, or most recently modified? (Date) \ 2. - q <1 and why? . 0 Home came with system D Response to inspection program 0 Water in basement ~ Previous system failed a Other B. ROOF LEADERS o Yes "'No , DISCHARGE o Near OAway C. YARD DRAINS BEAVER SYSTEM qYes DYes ~No !L'No WINQOWWELLS DYes JIlNo D. PROPERTIES WITH SUMP PUMPS ~ When does pump run? 0 Fall 0 Summer - 0 Spring (check all that apply) How often does pump run? ~ 01'1I ,I fa M~ Where does pump discharge to outside? D Front ~Back - D Winter 1iil Side ............................................................................................................................................................................................................................................................................................................................................................................................. NOTES: SUMP PUMP SYSTEM: }g PASS o FAIL You have 30 days to bring your system into compliance with current regulatio/l1J. Please call 9521447 -9833 for a re-inspection appointment. Is there another place where clear water enters the sanitary sewer system? ;0 Yes Ji'l1 No Where is this location? This area will need to be fixed so the clear water discharges to the storm sewer system. Inspector Resident: Date: Date: CS-qfD& . I ~- ~ ( . 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. Re>i~t Uw M~ 'I S(q/pz. ~ i A. B. C. D. 'rn,\ ~ City of Prior Lake Sump Pump and III Reduction Inspection FOill! J AfP+ 1 Name: Jtf(~5 / f;(/f/f'fl~V r ") pC! (" (" , Date'. 12-- 21-7('0 TI'me', 1/ C~/p f ~ .m. Second )( Age of Home: 1. \ Ita 01 f( FOr Ie 0~ ek 4v~ 5E Prior Lake, MN 55/)11, Phone: '1l/7-5225"" First ~ection, 0 Own:)9.. ~~: 0 Residential~ Non-Residential: 0 Address: BASEMENT 0 Yes ){ No WATER IN BASKET !BYes oNo WATER IN BASEMENT (flow over floor) SUMP BASKET 0 0 "M. 1 0 2 0 3 SUMP PUMP oOxfl 0203 DYes <<No CISTERN 0 Yes ~ No c:J" '0 (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 )ci Outside o Other Prior to Inspection: When was system installed, or most recently modified? (Date) \1, qq and why o Home came with system a Water in basement ~ Response to inspection program 0 Other o Previous system failed o Yes ~ No DISCHARGE: 0 Near 0 Away o Yes ~No WINDOW WELLS 0 Yes)("No o Yes~ No ROOF LEADERS: YARD DRAINS BEAVER SYSTEM PROPERTffiS WITH SUMP PUMPS ' When does pump run? 0 Fall 0 Summer )( Spring (check aU that apply) How often does pump run? Where does pump discharge to outside? 0 Front 0 Back o Winter / ~ Side -----------------------.---------.-------------------------.-.-.---.-----.-.-.---------.-.-----.-.---.-.-.-------.---------------.- NOTES: SUMP PUMP SYSTEM: )( PASS o 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. :r( No Is there another place where clear water enters the sanitary sewer system? 0 Yes Where is this location? .lwate This area will need ~,,' 'fft~, ofhe Cl.ea~r discharges to the storm sewer system,.", _ Inspector: I." \'- ,\' ~ Date: \ '- ./.f;). -l( \ Resident: ~ iL U, L.?~:"9--- Date: / l - t.. ~I .,! )' I Disclaimer: This Visuat"inspe~ion is done with due diligence to find obvious clear water cross-connections and does not imply the structure meets all City Codes. -.c.t' Y II . C. ~, e ow. It}ti' l: Pink: HRG White: Homeowner i~ ( A. City of Prior Lake Sump Pump and III Reduction Inspection Form NP/~// Name: dpl9c..6, lJ ~HES Date0-/0.-9'0Ti~Oa.m./p.m. / Sf: J/ ,Q / r _ /l L1 First I~sp~n ~nd 0 Addressf{pJO /^I.;C~~'-e C:e~EG HV Own: l!r"' R=-nt:j;L. Age of Home:Z J I..{f-.) f -?,. j ;; ;; Residential: g-- J Prior Lake, MN 550 ~ Phone:Y70 4"100 Non-Residential: 0 / - I IvC) We I~ /-- . ./" ~ BASEMENT ~s 0 ~ SUMP BASKET 0 0 ~ ~ 0 3 0 WATER IN BASKET ~s oNo SUMPPUMY 0 0 ~o 2 0 3~ WATER IN BASEMENT (flow over floor) 0 Yes ~ CISTERN 0 Yes o~ (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 ~dry tub 0 Sanitary sewer 0 Outside at Inspection: 0 Floor drain 0 Other B. C. Prior to Inspection: When ~tem installed, or most recently modified? (Date) ~me came with system 0 Response to inspection program o Water in basement 0 pre~ious s~iled ROOF LEADERS: 0 Yes B1iV DISClIARGE: 0 Near 0 Away YARD DRAINS 0 Yes~~ WlNDOWWELLS 0 Yes~ BEAVER SYSTEM 0 Yes!tY1<fO and why o Other D. PROPERTIES WITH SUMP PUMPS , ~ When does pump run? 0 Fall ~ummer (check all that apply) How often does pump run? Where does pump discharge to outside? 0 Front Spring 0 Winter ;:J eDi.. iF I.{ C vi e t<.- O Back ...., 0 Side NOTES: ~- ;1../us{J/J,va C$.t: t:;.C !owJ ./ SUMP PUMP SYSTEM: 0 PASS D4AIL You hav~s~;t;g your system into compliance with current regulations. When you are ready for reinspection. call 651/644-1469 for on ~ent. Is there another place where clear water enters the sanitary sewer system? 0 Y es ~ Where is this location? _ This area will n.e eeedd t too b b~t, e~.. e.,clear ate~discharges to the storm sewer sy~tem. Inspector: ~.f 0; ... Date: 3-10- 9CJ Resident:",:!:l:J'~-{' Date: ..3-/ 0- ~9 r ,\ .. ) '" Disclaimer: This. isual1DSpecfion is done with due diligence to fmd obvious clear water cross-connections . and does not imply the structure meets all City Codes. .'t White: Homeowner Yellow: City Pink: HRG J