HomeMy WebLinkAboutSump Pump Inspection
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City of Prior Lake
Sump Pump and III Reduction
Inspection Form
Name:~411'1
Prior Lake, MN 55
Phone:
Date:f:;;!{,-~Time:~Oa.~)
First I~ection ~ Second 0
Own: ~ Rent: 0 Age of Home:
Residential: ~
Non-ResiderrttaI: 0
'\
~.
Address:/6W'5 -::z:;.;~tlAj)ONA ~1I1,R.
A.
BASEMENT 0 Yes ~o SUMP BASKET ~o 0 1 0 2 0 3 0
WATER IN BASKET dY~ ONo SUM~~P 0 0 1 0 2 0 3 0
WATER IN BASEMENT (flow over floor) 0 Yes ~o CISRN 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 0 Response to inspection program 0 Other
o Water in basement 0 Previous system failed
B. ROOF LEADERS: 0 YesA No DISCHARGE: 0 Near 0 Away
C. YARD DRAINS 0 Yes ~ No WINDOW WELLS 0 Yes 0 No
BEAVER SYSTEM 0 Y es ~ No
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
_._._._._._._._._._~ '.-'-.-.-.-WQ- .-.-.-.-tpf.-.-. .-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-
NOTES: I '" - I .l '
.-L--~ ~ '""' -
SUMP PUMP SYSTEM:
X PASS
o 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.
)(No
DYes
Is there another place where clear water enters the sanitary sewer system?
Where is this location?
This area will ~o ~xed so the clear, water r~ti'U'fes to the storm sewer system.
Inspector: ~(';) A 4..1.....~~ Date: ir-tdlh
Resident: - Date:
r
-'7'7
Disclaimer: This visual inspection is done with due diligence to fmd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG
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City of Prior Lake
Sump Pump and III Reduction
Inspection FOill1
D.
Name: Rc<~ ~; V\ ,
Po L. ..." +
Date: 7- 2 '1 '1 Time:LlJo a.m./p.m.
First Inspection ~econd 0
Own: 8 Kent: 0 Age of Home: ftJ JtjI.i ?
Residential: e-- /
Non-Residential: 0
A.
BASEMENT ~ 0 No
WATER IN BASKET 0 Yes 0 No
WATER IN BASEMENT (flow over floor)
SUMPBASKET ~O 1 02 0 3 0
SUMPPUMP ~0102030
o Yes I3"NO CISTERN 0 Y es ~
(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.)
SUMP PUMP SYSTEM:
Address:--.!6 t I j,- I A)(., L-1 A DoN 4- Br...d elf
Prior Lake, MN 55 J7.:J.
Phone: l.f'T?'.2;-7 3
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)
o Home came with system
o Water in basement
and why
o Response to inspection program
o Previous system failed
o Other
-,,.."'...., ,'-<".~'"
B.
C.
o Yes-Et"'NO
o Yes~
o Yes CJ-N()
DISCHARGE: 0 Near 0 Away
WINDOW WELLS ~s 0 No
PROPERTIES WITH SUMP PUMPS
When does pump run? 0 Fall 0 Summer 0 Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? 0 Front 0 Back
o Winter
NOTES:
-----------------------------------------------------------------------------------------------------------------------------------
o Side
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
~ 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.
L3-NO
Is there another place where clear -water enters the sanitary sewer system? 0 Yes
Where is this location?
This area will need to be fixed 8.0 the clear water discharges to the storm sewer system.
Inspector: -- U ~ hv1~_ ..-
Resident: ,/'~- ~ ~
,
Date:
Date:
7 - 7 '1- .,?
/- 29-1'1
. .
Disclaimer: This visual inspection is done with due diligence to fmd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG