HomeMy WebLinkAboutSump Pump Inspection
",., .'i . ,1r . -
City of Prior Lake
Sump Pump and III Reduction
Inspection FOIII!
Name:lll/~)"fi ~, TE JPnt'Ylt: J. PHY<.1d....S
,.....
Date:. q -oJ 1-'1 C; Time:
a.m./p.m.
Prior Lake, MN 55
Phone:
First Inspection ~
Own: ~ Rent: 0
Residential: ."Q
Non-Residential: 0
Second 0
Age of Home:
Address: 15../; {; 3 / JtJ L hJ t..,rr /)t)t Nt=..
A. BASEMENT 0 Y es ~ No SUMP BASKET l( 0 0 1 0 2 0 3 0
WAlEK IN BASKET 0 Yes 0 No SUMP PUMP ~ 0 0 1 0 2 0 3 0
WATER IN BASEMENT (flow over floor) 0 Yes )Q No CISTERN 0 Yes 0 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
at Inspection:
o Laundry tub
o Floor drain
o Sanitary sewer
o Other
o Outside
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
o Home came with system
o Water in basement
o Response to inspection program 0 Other
o Previous system failed
o Yes';:(J No DISCHARGE: 0 Near 0 Away
o Yes 01 No WINDOW WELLS 0 Yes 0 No
o Yestf No
C.
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
B.
D. PROPERTIES WITH SUMP PUMPS
When does pump run? 0 Fall 0 Summer 0 Spring 0 Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? 0 Front 0 Back 0 Side
-'-'-'----------~('~r-'-'---------'-'---'---'---i~-'l-------------.-.---.-.-.-.---------------------------.---.-.-.-.-.-.-----.-.---
NOTES: ~ IIZ..I.4"/ 0": "'"-"11 '! .
"
,
SUMP PUMP SYSTEM: . PASS 0 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? 0 Yes )g No
Where is this location?
This area will ~to b~xed so the c~ear wa}Miischarges to the storm sewer system.
Inspector: 0 (~0-~ Date: tf-4;2I- <1 5'
Resident: (I Date:
Disclaimer: This visual inspection is done with due diligence to t"md obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG
City .of Prior Lake
Sump Pump and III Reduction
Inspection FOilll
Name: /1;~ ~E: e" JE ,eOl-1.E Date 0 - / / - 99Timet83 a.m.lp.m.
/ ..t'" ~ /J J / - First Insp~n ~ond 0 I. /
Address: /0.,:)"6.3 c A ~j\{U / /),; N:t: Own: rJi' Rent: 1:1 Age of Home:)Vji S
/} / i/.. ~ /, Residential: ~
Prior Lake, MN 55,-,?:N Phone'Y~7...8 /7'9 Non-Residential: 0
r!ud>6'~ ~
A. BASEMENT ~ Oflo
WATER IN BASKET Mes 0 No
WATER IN BASEMENT (flow over floor)
,/o/pp/7'
,/
SUMPBASKET oy~ 02 0 3 0
SUMP P~ Q""o 0 1 0 2 0 ).---/0
DYes IZJ..NO CISTERN 0 Yes o.MO
(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:
o Laundry tub
o Floor drain
o Sanitary sewer 0 Outside
o Other .r-
B.
C.
Prior to Inspection:
Whe~s system installed, or most recently modified? (Date)
ib/Home came with system 0 Response to. inspection program
o Water in basement If 0 Previ system failed
~ \ ~~ .
ROOF LEADERS: tf-o~ es ~o DISCHARGE: 0 Near ~ay
YARD DRAINS 0 Yes~ WINDOW WELLS 0 Yes~
BEAVER SYSTEM 0 Yes t:Yf.lo
and why
o Other
D.
PROPERTIES WITH SUMP PUMPS
When does pump run? 0 Fall 0 Summer
(check all that apply) How often does pump run?
Where does pump discharge to outside? 0 Front
OS~
o Back
.r-
o Winter
o Side
-----------.---------------------.-----------------------------------------.-----------.-----.---------------.-------.-------------
NOTES:
/
SUMP PUMP SYSTEM: ~SS 0 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 ~ent.
Is there another place where clear water enters the sanitary sewer system? 0 Yes IZJ..-N()
Where is this location?
This area will need to b~e~ the cle~a~ischarges to the storm sewer system.
Inspector: ~ .&~~ Date: ...3-/1-99
Resident: ~ ~..r?./ ~ ~./? ~ Date: <>..-3- 1/- 99
Disclaimer: This visual inspection is done with due diligence to t"md obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG