HomeMy WebLinkAboutSump Pump Inspectionr ~ ~ ~-
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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
at Inspection:
~ Laundry tub ~ Sanitary sewer ~ Outside
~ Floor drain O Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
O Home came with system
~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
and why
~ Response to inspection program ~ Other
C7 Previous system failed
O Yes ~ No DISCHARGE: ~ Near Q Away
~ Yes ~ No WINDOW WELLS ~ Yes ~ No
~ Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? C7 Fall a Summer Q Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:~---•-/~i^% ~f` ~ c c~./ `" ~ ~~n ~ ~~ ---•-Lt~~7""_ '---•---•---•---•--
SUMP PUMP SYSTEM: ~PASS ~ FAIL You have 30 days to bring your system into compliance with current
( ~ regulations. When you are ready for reinspection, ca11651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~No
Where is this location?
This area wi~o be fiy~qd so the clear water dis~rges to the storm sewer system.
Resident:
Date: :~ D
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
A. BASEMENT ~ Yes ~No 5UMP BASKET ,~. 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ No SUMP PUMP ~0 G 1 d 2 O 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~No CISTERN D Yes ~''No
~.~ ~~,,~.1 '~ ~~j~~
Name: ~ /~ W ~
City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
Address: ~~~,, 1 ~,Nn.~~,~' ~~ ~..
Prior Lake, MN 55 Phone:
Date: 9~- ~= `~ Time:'~a. p.m.
First Inspection ~' Second ~
Own: l~ Rent: ~ Age of Home:
Residential:~'`
Non-Residenhal: ~
A. BA5EMENT ~ Yes ~ No SUMP BASKET ~ 0 ~ 1 ~ 2~~ 3 ~
WATER IN BASKET ~ Yes O No SUMP PUMP :~' 0~ 1 ~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes ~No CI5TERN I~ Yes ~ 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:
~ Laundry tub ~ Sanitary sewer Q Outside
~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
Q Home came with system
~ Water in basement
B. ROOF LEADER5:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program ~ Other
~ Previous system failed
~ Yes~'No
~ Yes ~ No
~ Yes ,~ No
D. PROPERTIES WITH 5UMP PUMPS
and why
DI5CHARGE: 17 Near ~ Away
WINDOW WELLS ~ Yes D No
When does pump run? ~ Fall Q Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front 17 Back ~ Side
NOTES: .J?~~2/A l~~ P6E.'U,P. /'YfF~~-- ---"~,P~ ~~~„S'r-~--~SU---._._._.
SUMP PUMP SYSTEM: ~PASS O FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[1651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~ No
Where is this location?
This area wil},Hee~ to b~e.~'ixed so the clear w~ discharges 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
~(1
1
Q~
„~ ~
F~ i
1
~~
~,
City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
f.
Name: ~~° W i S~ ~'~ y^~Nll ~~` ~,~~~.~~ <, Date: ~-/J - 9y Time: I~~OC1 a.m./p.m.
First Inspection ~Second 17
Address:, ~,~~ ~ , r~,~ f n C~~'. /U ~ Own: ~''Rent: ~ A~e of Home: .~
Residential: Q'"
Prior Lake, MN 55~ Phone: ~~~7.'~ Non-Residential: ~
V,/ti~~(JN 1
A. BASEMENT L~'i'es U No SUMP BASKET O''U~ ~ 1 ~ 2 L7 3 L7
WATER IN BASKET ~ Yes ~ No SUMP PUMP ~~ 1 ~ 2 ~ 3 t~
WATER IN BASEMENT (flow over floor) ~ Yes [~o CISTERN ~ Yes A'l~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 ~ 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
~ Water in basement 17 Previous system failed
B. ROOF LEADERS: ~ Yes 13''~To DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes t~1Qo WINDOW WELLS ~ Yes L3'~
BEAVER SYSTEM ~ Yes C~-iQ'~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall L? Summer D Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ASS I~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca11651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C-~''No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: ,,I-/~- 99
Date: 5- /1 - 9 %
Disclaimer: This visual inspection is done with due diligence to fmd obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City
Pink: HRG