HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~~,~ ~,-
~
Name: L'~~~~J~~~~ ~~~G~~ Date: ~~-'9.~ Time;fi2oOa.m./p.m.
,~/ First In_~s~p~ ion Second ~
Address: ~~~~~ J`~'/~~.~,~~c/O ~-/ ~(/~ Own: 11~' Rent: Age of Home ~Q.S
~/ Residential: ~
Prior Lake, MN 55,~~i~f Phone:~~7-'Y~/~ Non-Residential: D
~v v ~vc ~ ~.,
A. BASEMENT es ~ No ~ SUMP BASKET ~~ 1~ 2 ~ 3 ~
WATER IN BASKET Q Yes o SiJMP PU1~I'P 0 O 1 C] 2~j3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~o CI5TERN ~ Yes ~'1~10
(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: I~
~ Laundry tub
Floor drain O Sanitary sewe~r ,. ~
~ Other Outside
Prior to Inspection: /
When was system installed, or most recently modified? (Date) and why
~ Home came with system 17 Response to inspectionprogram ~ Other
~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS Q Pre 'ous system failed
~ Yes ~ No DISCHARGE: ~ Near
~Y~N '' WINDOW WELLS C~
~ Yes C
~way
Yes CtJ~i'~o
BEAVER SYSTEM ~ ~
Yes ~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run? _
V~here does pump discharge to outside? ~ Front
NOTES:
~ Spring ~ Winter
.--
~ B~Ck ~ Side
SUMP PUMP SYSTEM: ASS ~ FAIL You have 30 days to bring your system into compliance with curr
regu[aaons. When you are ready for reinspection, ca11651 /644-1469 for an ointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to be d e clear ter arges to the storm sewer system.
Inspecto~:';~, , ._ , Date: - ~ -
. __ ,
Reside~it: ~ ~- _- , , , C_.~ _ !~ Date: . - -
Disclaimer: This visual insp~ction 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
Pink: HRG
~ r ~~.~~`r"~ ~:, ,~~ ~.) .
City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name ~~.' ,~-/ ~ p ~ '~ ,~" ,iQ.,,_ Date: - ,? - ~'i Time: a. m. /p. m.
~~~„~~ f,~ p~ ~/ First I~spection O Se~cond D
Address: f~'~~/~rL,+~L~ik' ,~/V~ Own: ~ Rent: L7 A e of Home:
Residential: ~
Prior Lake, MN 55 Phone: Non-Residential: ~
A. BASEMENT ~ Yes ~ No SIJMP BASKET ~ 0 Q 1 L~ 2~ 3 ~
WATER IN BASKET ~ Yes ~ No SUMP PUMP ~ 0 O 1 ~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes ~,No CI5TERN ~ Yes f~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 ~ Laundry tub ~ Sanitary sewer C1 Outside
at Inspection: Q Floor drain ~ Other
Priar to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program Q Other
Q Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes i~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAIN5 Q Yes ~ No WINDOW WELLS ta Yes ~ No
BEAVER SYSTEM ~ Yes J~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer ~ Spring a Winter
(check all that apply) How often does pump run?
V~here does mp discharge to outside? a Front ~ Back O Side
- ----- / y~ } ~~~~~ ~,~f
NOTES: / ~~+~'/3~~,~ nC ~_ --`--/ _~~~'~l,t.~f -~ -•-•-•-------•-•-•-•-•-•-•-•-•-•-•-------._
5UMP PUMP SYSTEM: ~J PASS 17 FAIL You have 30 days to bring your system into compliance with current
regulations. 4Vhen you are ready for reinspection, caU 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 w~eec~ be f,r~d so the cleax water~harges to the storm sewer system.
Resident:
Date:
Date:
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