HomeMy WebLinkAboutSump Pump Inspectioncann~I
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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 ~ Laundry tub ~ Sanitary sewer `~ Outside
at Inspection: Q Floor drain O Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~ a~ and why
~ Honne came with system ~ Response to inspection program ~ Other
Q Water in basement t7 Previous system failed
B. ROOF LEADERS: Q Yes~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes No WINDOW WELLS ~ Yes,~ No
BEAVER SYSTEM ~ Yes l~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall a Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front Q Back Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS 17 FAIL You have 30 days to bring your system into compliance with currenl
regulations. When you are ready for reinspecrion, ca[l 651/644-1469 for an aPpointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~ No
Where is this location?
This area will~ue~~bf~xed~o thenc}ear water discharges to the storm sewer sy~tem.~
Resident:
Date: `T~~
Date: l~ - 1 i _
Disclaimer: 'I'his visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnly the structure meets all City Codes.
White: Homeowner Yellow: City . RG
A. BASEMENT ~;Yes ~ No SUMP BASKET ~ 0 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~No SiTMP PUMP O 0 1~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTE ~ Yes ~No
~~~ pRI~~~, City of Prior Lake
~ ~ Sump Pump and I/I Reduction
~
INNES°`~ Inspection Form
Name: ~~~G~~~ Date: ~~ ZZ d Z Time: ~(~'• ~ am/~ ~
~
Inspection: ^ First ~ Second
Address: Z~~J ~~r ~~ V~ ,~ Own p Rent Age of Home: ~~S
Prior Lake, MN 55372 Phone: 1-2~ ~~ ~Residential ~ Non-Residential I
A. BASEMENT ~ Yes ^ No SUMP BASKET ^ 0 ~ 1 ^ 2 p 3 ^
WATER IN BASKET ~ Yes ^ No SUMP PUMP ^ 0 ~ 1 ^ 2 p 3 ^
WATER IN BASEMENT O Yes ~ No CISTERN O 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 p Laundry tub
at Inspection: p Floor drain
p Sanitary sewer
p Other
Prior to Inspection: : /~~
When was system installed, or most recently modified? (Date) ~~~ •/-~~~ and why?
^ Home came with system p Response to inspection program ^ Other
p Water in basement ~ Previous system failed
B. ROOFLEADERS ^ Yes '~No DISCHARGE ^ Near pAway
C. YARD DRAINS ^ Yes ~ No WINDOW WELLS p Yes ~No
BEAVER SYSTEM ^ Yes t~-No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall O Summer ^ Spring ^ Winter
(check all that apply) How often does pump run? t1~~J~W1~~' ~~tJ~-~ ~V~ ~~t%'~
Where does pump discharge to outside? ^ Front ^ Back ~- Side
rro~s: Ow~~ ~ ~ ~~c-u rJ~ ~Pi~PE~TY ' C'.tt~t,l! ~~I ~-~- -N~N ~nl N~~ -~-~-~-~-~-~-~-
1~r2 ~~ ~JA2~ ~ 1.~15~:~'7~tJ ~ P~1NG, Zc~~ ~~-' ~
SUMP PUMP SYSTEM: S$ f PASS ^ FAIL You hare 30 days In hring your ay.rlen~ iNO coruplinnce wilh cnrre~u
regula~ions. When yox are ready for re-in.+rec~ion, ca!/ 9521447-9833. for u~i appoiunnen~.
Is there another place where clear~water enters the sanitary sewer system? ~ Yes ~No
Where is this location?
This azea will need to be fixed so the clear water discharges to the storm sewer system
Inspector: Date: I ~'~Ip2
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.
~ Outside
~W~ ~ Gor°`~ 1-.1.~( t~'i~ 3~2z ~oZ ~-~'
.~ .
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.~ ~~ ~ .. ~ 6~ _ a . . ~ .
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
Name: Vt.~n r't"~ e V ~~ ~~ ~
Address: 2~4'~? ~.~~ ~r+ n P .~ ~
Prior Lake, MN 55~ Phone: ~~! 7- 6~~ 7
Date: ~'. ~ ~ . ,q Time: /~ l~a.m./p.m.
First Inspection L'1'~rSecond ~
Own: 13~"~Rent: ~ Age of Home:~~
Residential: L~'''
Non-Residential: I~
A. BASEMENT ~C-~'Yes ~~ No SiJMP BASKET ~ 0 ~~ 2 ~ 3 ~
WATER IN BASKET ~~" ~ Nq SUMP PUMP ~ 0 Q'?r a 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes A~o CI5TERN ~ Yes L7~#~
(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 a Laundry tub ~ Sanitary sewer l~0utside
at Inspection: I~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) c~~- ?' ~ and why
~ Home came with system ~ Response to inspection program ~ Other
r I~ater in basement ~ Previous system failed
B. ROOF LEADERS: Q Yes A''iC"~o DISCHARGE: ~ Near ~ Away
G YARD DRAINS ~ Yes ~o WINDOW WELLS Q Yes B-~
BEAVER 5YSTEM ~ Yes ~'~V"~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall C~''S`~ummer pring ~ Winter
(check all that apply) How often does pump run? -~'~{-- f~~ (G i~ 1
V~here does pump discharge to outside? a Front ~ Back A-~Sid~e
NOTES: ~---------~~~P X' /~~e. -•-•-•---•-~---•---•---•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•---•-•-•-•-•---•-•-
SUMP PUMP SYSTEM: Q PASS AIL 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 B''l~o
Where is this location?
This area will nee~ be fixed so the clear water discharges to the storm sewer system.
Inspector: ~^~1 Date: / - ~ ~ -
Resid~nt: Date: - ,~a? .
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all Cit.y Codes.
White: Homeowner Yellow: City Pink: HRG