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HomeMy WebLinkAboutSump Pump Inspection~~X 5 A. BASEMENT Jl~Yes ~ No SUMP BA5KET ~ 0 ~ 1 ~ 2 O 3 ~ WATER IN BASKET O Yes ~ No SUMP ~PUMP ~ 0 1~ 2 ~ 3 O WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes 1~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 ~ Laundry tub ~ Sanitary sewer ~ Outside at Inspection: ~ Floor drain ~ Other Prior to Inspection: When was system installed, or most recently modified? (Date) '~ and why ~ Home came with system ~ Response to inspection program ~ Other ~ Water in basement Previous system failed B. C. D. NOTES: ROOF LEADERS: 17 Yes L~ No DISCHARGE: ~ Near ~ Away YARD DRAINS ~ Yes No WINDOW WELLS 17 Yes ~ No BEAVER SYSTEM 17 Yes ~ No PROPERTIES WITH SUMP PUMPS When does pump run? O Fall ,~ Summer ,y~Spring ~ VVinter (check all that apply) How often does pump run? V~here does p~mp discharge to outside? ~ Front Back ~ Side SUMP PUMP SYSTEM: ~ PASS ~ FAIL 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 appoi-ument. Is there another place where clear water enters the sanitary sewer system? ~ Yes '~ No Where is this location? This area will need to_ ~e fi~ed so the clear water discharges to the storm sewer system. Inspector: Resident: Date: G~' 1~ Date: ~:~ -/r. -!' Disclaimer: This visual 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 Pi • G ...i`,_ ~:. ..._p / ~~i ~ (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 Q Outside at Inspection: ~ Floor drain ~ Other Prior to Inspection: When was system installed, or most recently modified? (Date) and why Q Home came with system 17 Response to inspection program ~ Other Q Water in basement ~ Previous system failed B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near O Away C. YARD DRAINS ~ Yes ~ No WINDOW WELL5 ~ Yes ~ No BEAVER SYSTEM ~ Yes ~ No D. PROPERTIES WITH SUMP PUMPS When does pump run? O Fall ~ Summer ~ Spring L'1 Winter (check all that apply) How often does pump run? V~here does pump discharge to outside? d Front Q Back O Side NOTES:. .f~t-~.,., ~~ ~ is ~ h a ~-•--~~ c•---t~ •-•~ ~c~ ~ y~r ~ '---•-----•-•-•-•-•---•-•-----•---•-•-•-•-•-•---•-•- -~ SUMP PUMP SYSTEM: PASS Q FAIL You have 30 days to bring your system into compliance with current regu[ations. When you are ready for reinspection, call 651/644-1469,for an appoirument. Is there another place where clear water enters the sanitary sewer system? ~ Yes L~'No Where is this location? This area will need to be fixed so the clear water discharges to the storm sewer system. Inspector: ,u •; Date: `/- ~ ~ - q 9 Resident: ~ Date: f - ,~ ~ - ~ y Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections and does not unply the structure meets all City Codes. White: Homeowner Yellow: City Pink: HRG A. BASEMENT ~ Yes ~ No 5UMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~ WATER IN BASKET O Yes ~ No SUMP PUMP ~ 0 Q 1 ~ 2 ~ 3 Q WATER IN BA5EMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes ~ No ~~ . _`_ .-.- ,~ J City of Prior Lake Sump Pump and I/I Reduction Ins~ection Form Name: ~~~i~~ ~ ~~~-" /'~' Date:~ %~-~3 ~ Time:~~7 ~.m./p.m. ~~ /`!~!''~iy~y~ '7' ~~~~~ , ~~; 1 First Ins~on ~'Second Q ~ Address: ~ ~~ -~L•'J ~~~ ~J Own: ent: Age of Home: f ,~/ Residential: ~ ~ Prior ake, MN 55~~~ Phone:~"~~%~~~~ Non-Residentiai: ~ A. BASEMENT ' es ~ No~ /' SUMP BASKET ~ 0 [~~~_~1 2~ 3 ~ WATER IN BASKET t] Yes I~Qo 5UMP ~P~~ ~ 0 Q' 1 D 2~~~/~ ~ ~ WATER IN BASEMENT (flow over floor) ~ 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 of this form.) Discharge Point Q Laundry tub ~ Sanitary sewer t~butside at Inspection: ~ Floor drain ~ Other Prior to Inspection: When w system installed, or most recently modified? (Date) ~"" and why l~~came with system Q Response to inspection program ~ Other a Water in basement ~ Prev' s system failed B. ROOF LEADERS: es ~ No DISCHARGE: O Near ~ C. YARD DRAINS ~ Yes Q°N~ WINDOW WELLS O Yes CYNo BEAVER SYSTEM ~ Yes t~No D. PROPERTIES WITH SUMP PUMPS ~~ ~ When does pump run? ~ Fall [Di'Summer prin ~ Winter (check all that apply) How often does pump run? ~T~~ CA~ /~A/~ V~here does ump discharge to outside? ~ Front ck ~' e NOTES: ~---•-• ~..~ /~i~IS --- j'=C~~-•-•-~~S ~•-•-•-•---•-•-•---•-•-•---•-•---•-•---•-----•--- f~r ~~ SUMP PUMP SYSTEM: ~ PASS You have 30 days to bring your, em into compkance nh current reguladons. When you are ready for reinspection, ~al[ 651/644-1469 f an appoi ent. -,t,....... ~ __--_"-% 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 xe so the clear w er~charges to the storm sewer system. Inspector: ~ /~'`~` `""r Date: ...~ - ~ s' ~/ Resident: ,~ //~( , ~ ~ ~ ( ~ i Date: -13- I Disclaimer: This v si ual inspection is done with due diligence to find obvious clear water cross-connections I and does not implv the structure meets all City Codes. White: Homeowner Yellow: City Pink: HRG