HomeMy WebLinkAboutSump Pump Inspection
City of Prior Lake
Sump Pump and III Reduction
Inspection Form
Name:_h/\/t-tE Y. rYhtl/11I E L 'i --TO /.J V
'Pttss '&W ~ t.Uo/~,.~
Address: !L./3/ {A u Ct. t:J Ill.t ~L. N;::"
Date: X-~5-'17 Time:~;Ja.m.~
Prior Lake, MN 55
Phone:
First Inspection It!f
Own:J( Rent: 0
Residential: 'f({
Non-Residential: 0
Second 0
Age of Home:
11\,
A. BASEMENT LJ Yes 11.No SUMP BASKET ~ 0 LJ 1 LJ 2 LJ 3 LJ
WATER IN BASKET LJ Yes LJ No SUMP PUMP M 0 CJ 1 CJ L9: 3 CJ
WATER IN BASEMENT (flow over floor) CJ Yes ~o CISTERN CJ Yes y"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:
CJ Laundry tub
CJ Floor drain
CJ Sanitary sewer
CJ Other
LJ Outside
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
B.
C.
CJ Home came with system CJ Response to inspection program
CJ Water in basement CJ Previous system failed
ROOF LEADERS: LJ Yes ~NO DISCHARGE: CJ Near CJ Away
YARD DRAINS LJ Yes),(No WINDOW WELLS CJ YesCJ No
BEAVER SYSTEM CJ Y es~ No
PROPERTIES WITH SUMP PUMPS
When does pump run? CJ Fall CJ Summer CJ Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? CJ Front
LJ Other
D.
CJ Winter
CJ Back
-NOTEs~._.~Tpi,-E-._.z.'Dr:5-.-'=-'-7.-.17J1c;j#-r-'~~.-'-'J5iiJo_;:s.-.-.-'-.-'-'-'-
AtJ'i)v~ _.(:2~{)cgCj9110 HD~Je. PAsseD)
SUMP PUMP SYSTEM: X PASS CJ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, caI/651/644-1469 for an appointment.
XNo
CJ Side
Is there another place where clear water enters the sanitary sewer system?
Where is this location?
This area wil~ b~~d so the cl)ar wat;rmpcharges to the storm sewer system.
Inspector: ~ ..Jr~~ Date: 9--d1S--97'
Resident: ........ / Date:
,
DYes
Disclaimer: This visual inspection is done with due diligence to rmd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG
506~
~
City of Prior Lake
Sump Pump and III Reduction
Inspection Form
-""
Name: r-1A./,tE;( I1/C',4/fi)E.<.,
/11',0/;
Address:03/ ~l9a CL;;(/I:-€ ~ AlE
Prior Lake, MN 55 S 7"'& ~one.y4~...~
/~..,,__ I ./
/V vvv '-'Iv '--. /
A. BASEMENT ~es LJ No ./
WATER IN BASKET CJ Yes ~
WAu..R IN BASEMENT (flow over floor)
DateS -1/ - 99 TimlC~ 0 a.m./p.m.
First Insp~on ~cond 0 Z
Own: V Rent:jJ Age of Home: I <...rJ. 5
Residential: iY'" ~
N on-Residential: 0
./
SUMP BASKET .., ~ 1 CJ 2 LJ 3 CJ
SUMPP~ ~ Ci 1 CJ 2_ CJJ LJ
CJ Y es ~ CISTERN CJ Yes e-r:fo
(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:
CJ Laundry tub
LJ Floor drain
CJ Outside
CJ Sanitary sewer
LJ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
----
and why
CJ Home came with system
CJ Water in basement
CJ Response to inspection program CJ Other
CJ Previous~ failed
CJ Yes ~o DISCHARGE: CJ Near CJ Away
LJ Yes ~ WINDOW WELLS LJ Yes ~
CJ Yes ~o
B.
C.
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
D.
PROPERTIES W llJ:1 SUMP PUMPS
When does pump run? CJ Fall CJ Summer CJ Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? LJ Front LJ Back
LJ Side
CJ Winter
NOTES:
SUMP PUMP SYSTEM:
/'
cJl'PASS
LJ 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.
~.
DYes
Is there another place where clear water enters the sanitary sewer system?
Where is this location?
This area will need to b#e~h=- clear at?scharges to the storm sewer system.
Inspector: ,---4/ #~ Date: 3-/1- CJ9
Resident: --;. /T,K ~ Date: 3-11-;J;}
, ..-
Disclaimer: This K~ction is done with due diligence to rmd obvious clear water cross-connections
and does not impi'Ythe stfucture meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG