HomeMy WebLinkAboutSump Pump Inspection,_
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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: O Floor drain ~ Other
~;~ '
, <:
Prior to Inspection:
When was system installed, or most recently modified? (Date) Co and why
~ Home c~me with system
~ Water in ~asernent
B. RO~F LEADER5:
C. YA~RAINS
BEAVER 5YSTEM
LyJ'Response to inspection program O Other
~ Previous system failed
:!~Yes ~ No DISCHARGE: ~ Near Q Away
~ Yes t~No WINDOW WELLS ~ Yes ~No
~ Yes ~`No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? la Fall 17 Summer Spr' ~ Winter
(check all that apply) How often does pump run? Y'ti
V~here does pump discharge to outside? ~ Front O Back Side
NOTES:
SUMP PUMP SYSTEM: PASS Q FAIL You have 30 days tn bring your system into compliance with current
regulauons. When you are ready for reinspection, call 6~f'~~or an appointment.
Is there another place where clear water enters the sanitary sewer system? 17 Yes Q" No
Where is this location?
This area will need to be ~'ixed so the clear water discharges to the storm sewer system.
I Inspector: ~' z.-.- Date: `t I cJ ~ C~-f I
Resident;~ i ~~ ~~~ '~~ •~;,~~ `, ~ ~~- ~,- ._ Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG
A. BASEMENT d~'Yes ~ No SUMP BASKET ~ 0 I~'1 ~ 2 Q 3 I~
WATER IN BASKET Cl Yes O No SUMP PUMP ~ 0 t~`" 1 L7 2 O 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN Q Yes L~IVo
~~' ~ ~.
~~
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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 L~ Laundry tub ~ Sanitary sewer FJ'"Outside
' at Inspection: C~ Floor drain ~ Other
Prior to Inspection: ~
When was system installed, or most recently modified? (Date) .Jc, ~n ~ ~ and why
~ Home came with system ~~_ R~e,s,Ponse to inspection program ~ Other
D Water in basement ~revious system failed_
B. ROOF LEADERS: Ca Yes O No DISCHARGE: ~ Near Q Away
C. YARD DRAINS L'a Yes Q No WINDOW WELi,S Q Yes ~ No
BEAVER SYSTEM ~ Yes ~ No
D. PROPERTIES WITH SUMP PUMP5
When does pump run? t~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front C! Back 1~---~3i~i'~'
NOTES: -•--~~~' r. ~i ~v,-~ --- /-~ ~ 7~G/~r.I ~ w' ~ V G ~-- ~•-•--~~- .~ 7~y~ ~-eI~C.-•---•-----._._._._._.
SUMP PUMP SYSTEM: ASS ~ FAIL You have 30 days to bring your system into compliance wUh currcnt
regulations. When you are ready for reinspection, ca[l 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~'1~To
Where is this location?
This area will need to be fixed so the cl r water discharges to the storm sewer system.
Inspector: Date: 7- 07 7- 9 9
Resident: Date: ~-~ ~- 9 f
Disclaimers 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.
White: Homeowner Yellow: City Pinkc HRG
~ ~
A. BASEMENT F L~''Qes ~ No SUMP BASKET ~ 0 'L~''lr ~ 2 O 3 ~
WATER IN BASKET ~s ~ No 5UMP PUMP Q 0 ~~ 2 ~ 3 O
WA1'ER IN BASEMENT (flow over floor) ~ Yes ~o CISTERN ~ Yes ~3'1Qo
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: <~»`1~1 u c~, i.,~; ~ ~~i ~L ~~ .~ ~i l
Address: yf ~~ j ~, y~(; .,~~. ~/' ~
Prior Lake, MN 55 ;~~I Phone: ~-/~/ l~~~/l %
Date: ~ %~- J,y Time: ; /!-~ a.m./p.m.
First Inspection ~ Second ~
Own: ~"" Rent: Q Age of Home:~
Residential: C~-
Non-Residential: ~
,.,..~~ / ~~;~ t
A. BASEMENT Yes ~ No SUMP BASKET ~ 0 ~1 L7 2~ 3 O
WATER IN BASKET C'~'~es Q No SUMP PUMP 17 0 C'J'~1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) O Yes ~'No CISTERN a Yes ~-i4'"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 C~ Laundry tub O Sanitary sewer 0 Outside
at Inspection: Q Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)_
L3 Home came with system D Response to inspection program
la Water in basement O Previous system failed
~ Other
and why
t,..
B. ROOF LEADERS: ~~
La'Yes ~ No ~
DISCHARGE: ~'Near
~ Away
C. YARD DRAIN5 ~ Yes A'No WINDOW WELLS ~ Yes I~'No
BEAVER SYSTEM l7 Yes ~o
D. PROPERTIES WITH SUMP PUMPS
[ ~~
"
~
When does pump run? 7 Fall C~
Summer ~prin Winter
(check all that apply) How often does pump run? , ~- ~~~-~ , y 7Z <. ~~;
V~here does pump discharge to outside? L7 Front ~ Back ~ Side
NOTES: ~--~~,~-•-•- -- SC -•-~ ---/~•~ lr~ -•~~-•-•--- - -•--- - ---•---•-•-•-----•-•---•-•-----•-•-•-•-•-
SUMP PUMP SYSTEM: ~ PASS FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~'1~To
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ,~.t~ ~ Date: - /G - 9 y
Resident: Date: ( - / d - 9 ~
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.
White: Homeowner Yellow: City Pink: HRG ° „