HomeMy WebLinkAboutSump Pump Inspection• s
Discharge Point
at Inspection:
Name: ~ ~ ~~~ Y
Address: ~ ~4'~ ~ ~~"~~"~~ - S~„
Prior Lake, MN 55~,~: Phone: ~'' '~ ~
Date: (Q '~~ Time:~~/p.m.
First Ins ection ~ Second L7 1.~."(~Tl r
Own: ~ Rent: ~ Age of Home:
Residential: ~
Non-Residential: ~
A. BASEMENT ~Yes~ No SIJMP BASKET O 0 ~1 ~ 2 ~ 3 ~
WATER IN BASKET Yes ~ No SUMP Pj,R4IP ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BA5EMENT (flow over floor) ~ Yes 6~No CISTERN ~ Yes L~'No
B.
(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. )
City of Prior Lake
Sump Pump and I/I Reduction
ction Form
~ Laundry tub ~ Sanitary sewer ~Outside
~ Floor drain ~ Other
Prior to Inspection:
When was systern installed, or most recently modified? (Date) ~~ and why
O Home came with system y~Response to inspection program Q Other
Q Water in basement ~ Previous system failed
ROOF LEADERS: ~ Yes ~ No DISCHARGE: Q Near ~ Away
C. YARD DRAINS ~ Yes C~'1Vo WINDOW WELLS Q Yes ~ No y
BEAVER SYSTEM ~ Yes [~'`No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer Q~ ring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front Back Q Side
NOTES:
SU1V~P PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, caU$M~A~W for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~"" l~o
Where is this location?
This area will ne~d to~l~~,_~l- so the clear water discharges to the storm sewer system.
~
I Inspector: ~' Date: ~ f~' Ild~ I
Resident: t ,~ , ~... Date: T
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all City Codes.
White: Homeowner
Yellow: City
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Name: ~~.~ ~ ~ ~'
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C~~ty of Pri~or Lake
Sump Pump and I/I Reduction
Inspection Form
~
~ ~~~~~ ~'-~ ~ ~M ~ ~~ ~Date:. ~- ~~ ~9 Time: ~~? 5 a.m./p.m.
Address : ~`~ ~ ~ ~ ~ ~~ ~ ~f ~.~, C'~ /~ . ; ,c
Prior Lake, MN 55~ ?~ Phone: ` 7- r`~ ~
First Inspection l3' Second O
Own: ~'"' Rent: Q Age of Home: ) 7
Residential: L~'`
Non-Residential: ~
~~ / ~i ~,., ~-
A. BASEMENT I~'~es ~ No SUMP BASKET ~ 0 ~ L7 2~ 3 ~
WATER IN BASKET ~s ~ No SiJMP PUMP Q 0 ~~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~o CISTERN ~ Yes LL~#a
(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 Cl Sanitary sewer 17 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
Q Water in basement ~ Previqus system failed
r ~ , H ~ ~ [~~ ~
B. ROOF LEADERS: ~~I~I'es ~ No DISCHARGE: ~ Near L~Away
C. YARD DRAINS ~ Yes 13'N~o WINDOW WELLS ~ Yes ~~To
BEAVER SYSTEM ~ Yes L~'~
D. PROPERTIE5 WITH 5UMP PUMPS
When does pump run? ~ Fall a Summer Q Spring Q Winter
(check all that apply) How often does pump run? /(,~~°vi~ ~~. N,S
V~here does pump discharge to outside? O Front ~ Back O Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS L~T FAIL You have 30 days ta bring your system into compliance with current
regu[ations. 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? Q Yes ~~o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
I Inspector: G~/~'~'- Date: ~/~ 99 __ I
Resident: ~cz-v~,_ ~ ~~ Date: 7~ / - 99
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.
~ ;~ .., ~
~ ~' ,;z~,~;
White: Homeowner Yellow: City Pink: HRG
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~ C'ity of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
Name: U V ~~ ~ Y, ~. ~ a ~ ~~S ~-- .~ u ~ ~ ~t
Address: f,J ~/ ~ 7 `; f~ ~crvt ~/~. S~
Prior Lake, MN 55~~ Phone: ~/~/' -~S"6
Date: ~.~~ ~J ' Time: ~p p~ a.m./p.m.
First Inspection ~ Second ~
Own: I~ Rent: ~ Age of Home:
Residential: [7
Non-Residential: ~
~pss.+ ~ R ar r
A. BASEMENT I~'4~es ~ No SiJMP BASKET ~ 0 ~~ 2 ~ 3 ~
WATER IN BASKET 17~~Y'es ~ No SUMP PLTMP ~ 0 I~l O 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes I~-3Qo CISTERN ~ Yes I~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 ~ Laundry tub ~ Sanitary sewer L~~utside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) wE. -~, and why
~ Home came with system O Response to inspection program ~ Other
O Water in basement ~revious system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near CI Away
C. YARD DRAINS ~ Yes ~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes 17 No
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring a Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ac 17 Side
NOTES: ~(~s:~r.~-f-----~.,s t, /~rd ,,-~~~ ~ V G~ ~~-'vc.c ~s; ~(r.-•-----•-•-•-•-•-•-•-----•-•-
,.~.,,,~,
SUMP PUMP SYSTEM: ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations, When you are ready for reinspection, cal! 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 need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~? Date: ~' ~ ~ .
Resident: r , ~ Date: 7- ,? ~ -
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not impl_y the structure meets all City Codes.
~ ~:~
White: Homeowner Yellow: City Pink: HRG