HomeMy WebLinkAboutSump Pump Inspection,~~~ pRI°~ , City of Prior Lake
~ ~ Sump Pump and I/I Reduction
~rNNES°``~ Inspection Form
ANNUAL CERTIFICATION RE-INSPECTION 2002
Name: ~~ Date: ~ 2Q ~2- Time: 2~~ ~ a~pm
Address: CJ' ~-~GJ ~Zl i~ I f~ iA( I~ ~ r id~(~S ~ r ~spection: ^ Second :~~ Third
Prior Lake, MN 55372 ~ Own ^ Rent Age of Home: ~,
Phone: ~~Z." ~('' S~(p~J ~ Residential - ~ Non-Residential
A. BASEMENT .~,Yes ^ No SiJMP BASKET ^ 0 ~' 1^ 2 p 3 ^_
WATER IN BASKET ^ Yes ^ No SiJMP Pi1MP p 0 ~ 1 ^ 2^ 3^_
WATER IN BASEMENT ^ Yes ^ No CISTERN ^ 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 ^ Laundry tub
at Inspection: ^ Floor drain
^ Sanitary sewer
^ Other
Prior to Inspecrion: /
'
~
'~ (~~
1
When was system installed, or most recently modified? (Date) ~~ and why?
• p Home came with system ^ Response to inspection program ^ Water in basement
,~` Previous system failed ^ Other :
B. ROOF LEADERS ~Yes `^ No DISCHARGE ~( Near ^ Away
C. YARD DRAINS ^ Yes ~No WINDOW WELLS ^ Yes 0 No
BEAVER SYSTEM ^ Yes No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ^ Fall ^ Summer ~81 Spring ~ Winter
(check all that apply) How often does pump run? U !'d~( (15
Where does pump discharge to outside? ~ Front Back ^ Side
NOTES:
SiJMP PUMP SYSTEM: ~1 PASS ^ FAIL You have 30 days to bring your system into compliance witl~ current
regulations. Please ca/1952/447-9833 jor a re-inspection appointment.
Is there another place where clear water enters the sanitary sewer system? 0 Yes ~ '~ No
Where is this location? ~
This azea will need to be fixed so the clear water discharges to the storm sewer system
Inspectar: Date: ~ ~~
Residen . 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 Citv Codes.
,~' Outside
- ~ ~,e;~~~'~en~~ ~P~ luu~led ~~~z~~oz ~
~~
~
~
(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 ~ide
at Inspection: ~ Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~~ and why
~ Home came with system D Response to inspection program ~ Other
Q Water in basement ~evious system failed
B. ROOF LEADERS: ~ Yes Q No DISCHARGE: ~l Near a Away
C. YARD DRAINS O Yes ~ No WINDOW WELLS Ca Yes C] No
BEAVER SYSTEM ~ Yes D No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer a Spring ~ Winter
(check all that apply) How often does ~~ ~~
V~here does pump discharge to outside? ont ~ Back ~l Side
NOTES: -•-- ~i t, ~..,-~' - ---~- ~^~c ~~ ~lrc~ l~l{v~/-- -•~G-•-•---•-•-•-------•-------•-•-•-•---•-----•-•-•-•-•-•---•-•-
,
SUMP PUMP SYSTEM: .e''PASS ~ FAIL You hpv4 30 days to 6ring your system into compliance with cunent
regulations. When you aae rg~dy for reinspection, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~A''N~o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: , ~ Date: -Z 1-
Resident: Date: /, - ~ y - 99
-~
Disclaimer: This visual inspection is done with due diligence to find ob~ious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City : Pink: HRG
A. BASEMENT ~~ No 5UMP BASKET ~ 0 ~ O 2 ~ 3 ~
WATER IN BASKET ~s ~ No SUMP PUMP ~ 0 ~ Q 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ CI5TERN Q Yes ~~T'o
~R.a~i,~a.~~~~w _J~
~ ae. /
/
r
~~~
~,~~
~
City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
Name: / ' / ~~C7.C`.~~'',~ ,~ O,~/~ ~(, ;~
~/ ~ ~~ S ~~
Address:~'y~'J`~~"~/~,(„~icv.~.~ ~i~-lQ,~'.L-~
Prior Lake, MN 55 ~~~ Phone':~`'~~"~~'6~
~~'r
Date~-~~'~~ Tim~3 ~a.m./p.m.
First Inspection ~cond ~
Own: ~''"~ Rent: ~ Age of Home:_
Residential: L~'~
Non-Residential: ~
A. BASEMENT ~es L'~ No SUMP BASKET Q 0 ~''1 ~ 2 ~ 3 Q
WATER IN BASKET es I~ No 5UMP PUMP ~ 0 A'"1 ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes L~o J CISTERN O Yes I~io
(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 C~ Laundry tub ~anitary sewer Q Outside
at Inspection: IJ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system Ca Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: Yes ~ No DISCHARGE: ~ Near I~Away
C. YARD DRAINS Q Yes I~~~ WINDOW WELLS ~ Yes ~'No
BEAVER SYSTEM ~ Yes I~' No
D. PROPERTIES WITH SUMP PUMP5
When does pump run? C7 Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front C7 Back ~ Side
NOTES: r~lt X ~ose ,:~~n -• S-0n •-----•---------•-•-•-•-•-•-•-•-----------------------•-•-•-•-•---•-•-
SUMP PUMP SYSTEM: 17 PASS ~~~".~AIL You have 30 days to bring your system into compliance with current
reguladons. When you are ready for reinspection, ca[[ 651 /644-1469 for an gppointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L9~No
Where is this location?
This area will need to be fix~,d,so the ciear water discharges to the storm sewer system.
Inspector: - Date: ..~ - / y -
Resident: ~t-~ 1.~:t, ~,l%' Date: ~
Disclaimer: This visual inspection is done with due diligence to f'ind obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: I~RG :