HomeMy WebLinkAboutSump Pump Inspection~ ~
,~ 4 PRI°~~, City of Prior Lake
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" Sump Pump and I/I Reduction
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rNN$5~~ Inspection Form
ANNi1AT. CF.RTiFiCATION RE-INSPECTION 2002
Name: M.CC~.,I)I~("~
~~~ Address: ~5 ~ ~ ~GI ~-' ~~Yl ~b'(?~' ~r.
Prior Lake, MN 55372
Phone: ~~2," ~[ ~~ - ~`~Jr'J'
Date: ~f' 2 02 Time: ~ -~,/pm
Inspection: ~ Second ~ Third
~'j' Own ^ Rent Age of Home:
~ Residential ~ Non-Residential -
A. BASEMENT ~ Yes ^ No SUMP BASKET ^ 0 ~ 1 ^ 2 ^ 3 ^
WATER IN BASKET ^ Yes }~ No SUMP PUMP ^ 0 1^ 2^ 3^
WATER IN BASEMENT ^ Yes ~No CISTERN ^ Yes ~I' No
(If no pump, place sticker across edge of sump cov and basement floor so any removal of cover will break seal. Skip to Part B.) . _
Discharge Point ^ Laundry tub ^ Sanitary sewer ~ Outside
at Inspecrion: O Floor drain ^ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why?
.^ Home came with system p Response to inspection program ^ Water in basement
J~ Previous system failed ^ Other
• ;
B. ROOF LEADERS ~. Yes ^ No DISCHARGE ~ Near ^ Awa}~
C. YARD DRAINS ^ Yes ~"No WINDOW WELLS ^ Yes ~ No
BEAVER SYSTEM ^ Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ^ Fall ~ Summer '~ S,~? ring ~y ^ Winter -.
(check all that apply) How often does pump run? ~5 [~ 0~( rGU
Where 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. Please call 952/447~833 jor a re-inspection appoindnent.
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: _ ` ~ VI OZ
~
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. ___ _
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(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: :
Q Laundry tub ~ Sanitary sewer L~"Outside
~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date),
and why
~ Home came with system 17 Response to inspection program CI Other
Q Water in basement ~ Previous system failed
B. ROOF LEADER5: ~ Yes ~ No DISCHARGE: ~ Near a Away
C. YARD DRAINS ~ Yes ~ No WINDOW WELLS ~ Yes ~ No
BEAVER 5YSTEM ~ Yes D No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back &~ae
NOTES: ~ 'J~,~ //s ~ ~ ,/~.~ic-/ ~V ~ -{-~~ C~., .{ ' i cf ~ -•-•-•-----•-•-•---•-•-•---•-•-•-•-•-•-•-•-
SUMP PUMP SYSTEM: ASS ^ FAIL 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 appouument.
Is there another place where clear water enters the sanitary sewer system? l7 Yes Q'No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
.
Inspector: "~ . Date: ~ /~ '
Resident: ~ c ~ ' % ~. ,~ Date: ~ - /~ - 9~9
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not implv the structure meets all Citv Codes.
White: Homeowner Yellaw: Ciry Pink: HRG
A. BASEMENT ~ Yes ~ No 5iJMP BASKET ~ 0 Q 1 ~ 2 ~ 3 O
WATER IN BASKET a Yes Q No SUMP PUMP ~ 0 ~~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes d No CISTERN ~ Yes ~ No
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~,~~J ~
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Name: ~~ ~~~~~ , ~~.t1/,~~., Date:~`~'~~~Tim~07~7a.m./p.m.
~ ~~ ~~ ~,.--~-~
-~'~ " "-~(~ _ ~irst InLsp~ °on e-'" Second ~
Address:~~~~~i'~/~'~~~~/ U~O,~~~Own: ~ Rent: - Age of Home:~
`-~y ~ ~/,/ry Residential: ~ ,.
Prior Lake, MN SS~j ~ Phone" ?''7' /''~:~~~~ Non-Residential: ~
A. BA5EMENT es~ ~~ SITMP BASKET ~ 0 ~~ ~2~ 3 ~
WATER IN BASKET Q~Yes Q No SUMP P~~ O 0 ~1 ~ 2_~~ Q ~3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~~~Qo CISTERN ~ Yes D~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 Q Laundry tub ~ Sanitary sewer utside
at Inspection: ~ Floor drain la Other
Prior to Inspection: _,._..-
When as system installed, or most recently modified? (Date) and why
L"f Home came with system ~ Res onse to ins ection program ~ Other
P P
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~ DISCHARGE: Ca Near ~ Away ."
C. YARD DRAIN5 ~ Yes [`_,1'yN WINDOW WELLS ~9~'~es ~ No
BEAVER SYSTEM ~ Yes ~''NO
D. PROPERTIES WITH SL1MP PUMPS _ /~ ~~~
When does pump run? ~ Fall , ~'Summer ~r~' Spring ~ Winter
(check all that apply) How often does pump run? L J ~/~ -~E~-7 , E 3 ~ T~ie ~A/~ L~cIC~ T
V~here does pump discharge to outside? ~ Front ~ Back i e
NOTES-•-•-•---- ~~ E x --•-:.~%--•-~~ ~S / ~D -~----•-•-•---•-•---•-------------•-•-•-•---•-•-----•-•-•-
/O
SUMP PUMP SYSTEM: ~ PAS5 ~L You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[[ 651 /644-1469 for an appointment.
.---~"'"_
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~'1Q'Yo
Where is this location?
This area will need to be ed s e clear wat di~arges to the storm sewer system.
Inspector: .,~ ~,`~"`" '`"`" _ ~,.,-'" Date: ,~ - / ..~ - > >
Resident: ~ ~ ~ ~ Date: - ~ /'
Disclaimer: This vis~(1 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