HomeMy WebLinkAboutSump Pump Inspectionr.
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(If no pump, place sticker across edge of sump cover and basement floar so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point ~ Laundry tub I~ Sanitary sewer ,]~ Outside
at Inspection: O Floor drain I~ Other
`~ Prior to Inspection: Q
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. ROOF LEADER5: ~ Yes 1~ No DISCHARGE: O Near ~ Away
C. YARD DRAINS 17 Yes No WINDOW WELLS O Yes ~ No
BEAVER SYSTEM ~ Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? Ja Fall ~ Summer ~ Spring I~ Winter
(check a11 that apply) How often does pump run? }I, pQ. v tl Y'a i n,~"-, rn ~taJ Uvl~ ~"
~~.~ V~here does pump discharge to outside? ~ Front ~ ack .~, Side
NOTES:
SUMP PUMP SYSTEM: 1,~ PASS ~ FAIL You have 30 days to bring your system into comp[iance with current
regu[ations. When you are ready for reinspection, call$i4~for an appointment.
Is there another place where clear water enters the sanitary sewer system? l7 Yes ~ No ~^
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
~ Tnspector: , Date: ~ ~ Z~~~ C~"1~ ~
Resident: ~ ~ , f%' ~3z ~~ i -% / Date: T~
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
A. BA5EMENT ~ Yes ~ No SiJMP BASKET C~ 0~ 1 fa 2~ 3 ~
WATER IN BASKET ~( Yes ~ No SLTMP PiJMP ~ 0,~I 1~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) Q Yes Q No CISTERN ~ Yes ,~!'No
~,t; , +:~` F?
~ ~;~~ ~ 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 Q Outside
at Inspection: a Floor drain a Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
17 Home came with system ~ Response to inspection program ~ Other
t7 Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes ~ No WINDOW WELLS ~ Yes Q No
BEAVER SYSTEM ~ Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? D Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES: ~,E'S ~ra5 ~15"TA L [, E ~~---~~--~-c J ~-•-~•7 ~--- ~--•-•-------•-•-
~~-v
~u`~s-~~
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[l 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~--~~
Where is this location?
This area will need to b ed s~ clear w r d' ~rges to the storm sewer system.
Inspector:~ ~ I .
Resident: , /~i , L~
Date: a~ `'`?` -
Date: ~i - -
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
A. BASEMENT ~ Yes a No SUMP BASKET ~ 0 ~ 1 ~ 2 I~ 3 O
WATER IN BASKET O Yes ~ No SUMP PUMP ~ 0 ~ 1 ~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN a Yes ~ No
ts,~ ;~::
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City of Prior Lake
Sump Pump and I/I Reduction
ction Form
Name:~~'p I ~ g ,.~ )1'J, ~l;U~ ~ ~~(~~ ~,~
~~T
Address: ~.() ~~~ 9 ~r.~ r ~t /~-~1~' , ,.5~
Prior Lake, MN 55~ Phone: ~«- ~~~/
Date: `-,~ - 99 Time: ~/%~ a.m./p.m.
First Inspection l~
Own: Q" Rent: ~
Residential: C-#~"
Non-Residential: ~
Second ~
Age of Home: 1 ~
~ «~.r ~~/~ ~
A. BASEMENT C'~Yes ~ No SiJMP BASKET ~ 0 f~l ~ 2 a 3 ~
WATER IN BASKET 13'~es ~ No SUMP ~P~ P 17 0 t~l ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes [a"No CISTERN ~ Yes D~To
(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:
Prior to Inspection:
When was system installed, or most recently modified? (Date)
L~ Home came with system ~ Response to inspection program
~ Water in basement ~ Previous system failed
O Other
and why
B. ROOF LEADERS: ~ Yes C~ No DISCHARGE: O Near ~ Away
C. YARD DRAINS ~ Yes C~
~o WINDOW WELLS l7 Yes ~-]" No
BEAVER SYSTEM ~~
~ Yes C~' No
,
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? ~ Fall ~' Summer ~ Spring ~ Winter
(check all that apply) How often doe s pump run?
V~here does pump discharg e to outside? ~ Front ~ Back ~ Side
NOTES: ~r--~-~,•%GY--~~~ ~ ~ a ----~-~ ----~/o ~ ~ ---T~rc ~ v~ -•-•---•-•---•---•-------•---•-•-•-•---•----•-•-•-•-----•-•-
_ . ~{3,c+4~S
SUMP PUMP SYSTEM: a PASS ~FAIL You h~v_ e 30.~y~s.t6 br ng your system into campliance with current
regulations. When you are read~ y for reinspection, call 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? I~ 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: ~/- ~,Z,,i. - 9 9
,
Resident ,;.~~, ,:; ,~'`;~ , ~ ~-; , Date: ~/- ~,2a2 - yq
. :~
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.
~ Laundry tub O Sanitary sewer ~ Outside
~°'~loor drain ~ Other
White: HomeaWner Yellow: City Pink: HRG