HomeMy WebLinkAboutSump Pump Inspection: ~,~,.~;,.:,
(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 install~e~d, or most recently modified? (Date)
''~,
~` Home came with s~stem ~ Response to inspection program ~ Other
Q Water in basement I~ Previous system failed
and why
B. ~ ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near Q Away
~
C. ~ARD DRAINS ~ Yes L~ No WINDOW WELLS ~ Yes ~ No
`~BEAVER SYSTEM ~ Yes l4'rNo
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
.(check all that apply) How often does pump run?
Where does pump discharge to outside? 17 Front ~ Back ~ Side
NOTES~ ~~~'~])8 -* ---~;~'~(2- C~2 ~ I h~ ~- ~E al~SL~( I rJ ~-~ rS i N"f7~ -•----
~~~t~~T -~ -.1~ C' ~~~ ~ ~N~~'~-
T
SUMP PUMP SYSTEM: ~PASS d FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 9il~9~for an appointment.
~ 9~'2-y~{'1 ~`~833
Is there another place where clear water enters the sanitary sewer system? ~ Yes [a'` No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ' ~,~"'V' Date:
Resident: i ~ _ ~ _ ~ ~i-'" . 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 P'
A. BASEMENT C~Yes ~ No SUMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET d~Yes Q No 5UMP PLTMP ~ 0 [D~ 1~ 2 ~ 3 D
WATER IN BASEMENT (flow over floor) ~ Yes ~'No CISTERN ~ Yes ~'No
Y .. . ~
~'
~~~
~~1
1 ~'
~~~~
: ~ ~.
;~i~
i Name
. .. . ... ... .;s . aN .
~ C.'t ~ ` of Prr~r Lake
~
Sump Pump and I/I Reduction
Inspection Form
~~/ry~~ `"I '' ~ ~~a~~C~,~ Date: `~ "'~G" ~ ~ Time:~~~~m.lp.m.
~~ ~, ~~~~ ~~~~ ~~ ~-;% First In.speetion ~ Second ~"
Address: ~~~ ~ ~ Own: L'~J`~ Rent: ~ Age of Home:
~ ~
~' ~~ y~ ~, /~~~ ~ y,~~ Residential: ~'"f ~
Prior Lake, MN 55 v/~" Phone: ,y / 9 Non-Residential: ~
A. BASEMENT ~ Yes ~ 1RTo 5UMP BA5KET Q 0 ~ 1 ~ 2 ~ 3 O
WATER IN BASKET ~ Yes ~ No SUMP PUMP O 0 ~ 1 O 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes Q No CISTERN ~ 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 ~ Laundry tub ~ Sanitary sewer O 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 t7 Other
~ Water in basement ~ Previous system failed
B. ROOF LEADER5: la Yes ~ No DISCHARGE: Q Near ~ Away ~•
C. YARD DRAINS ~ Yes ~ No WINDOW WELi,S ~ Yes ~ No
BEAVER SYSTEM ~ Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? ~
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
~-- ~~~~/
NOTES: ~-----•-•-• ~~•C-e~,~-- /~/~ S"'-•/ /~ T--~ ~i`~ ~%4 N '-- ~ •-- ~U---•-•-----•-•-•-•-
G•
,U~~ /,~c~ / ~ L L'= ~
SUMP PUMP SYSTEM: ~ ~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready for reinspection, ca[I 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? O Yes I~ No
Where is this location?
This area will need to be f d so e lear water sc ~ges to the storm sewer syste~a.
I Inspector: /'"t-" f" j~~i1 `ll ` Date: '~ " i U"%~ I
Resident:' ~~ ,G~t'~"~,~",~"./` Date: - /C~-
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.
~ ~ '~ ~' ~' ,~~ °i
; t~' ~"~"'~
White: Homeowner Xellow: City Pink: HRG
~~" ;~
` .~ .~~l.e'
,
,~`~~n
~~
~~.
~~
~ Name:
., f .. .f 4 ~. '''~ . . ,. .. kw~.. . ..
q
~ C`i't~ `of P~~+~r Lake
Sump Pump and I/I Reduction
Inst~ection Form
~~J~'
~" ~i
i ~~.C/~`~(, ~..~,~,~.F'a,~ ~ / ~ '
~ Date: ~ Time:~~~~m./p.m.
, /~~~~~~/v /1~~„~ ~~_, First Inspe,~tion A~'~ d ~ ~ ~
Address: ~..~~~~ G~-~ ~~~~ Own: f~'~~ Rent: tJ Age of Home:
'/ ,,,, Residential: Lg'` ~
Prior Lake, MN SS~~Z Phone~`~~~~1~9 Non-Residential: ~
A. BASEMENT I~es ~~p~" 5UMP BASKET ~ 0 L~1!-~ 2~ 3 ~
WATER IN BASKET o•~x-es a No SUMP PU1~R ~ 0 I~1 ~ 2 O 3 ~
WATER IN BASEMENT (flow over floor) O Yes 1~1o CISTERN ~ Yes ~
(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 system installed, or most recently modified? (Date) and why
Home came with system L'1 Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes U No DI5CHARGE: ~ Near O Away
C. YARD DRAINS ~ Yes m~/1V~o,.~'~ WINDOW WELLS es ~ No
BEAVER SYSTEM a Yes ~Lfifo
D. PROPERTIE5 WITH 5UMP PUMPS ~/~~
When does pump run? ~ Fall I~ Summer ,,S,Pring ~ Winter
(check all that apply) How often does pump run? Y'T~~ ~ia /~ ~
Where does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES
SUMP PUMP SYSTEM: ~ PASS IL You have 30 days to bring your system into compliance with currtnt
regu[ations. 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? ~ Yes Yy-r~
Where is this location?
This area will need to b x~the clea~at~scharges to the,storn~l sewer system.
,
t:
I Inspector: ~`'`~' Date: "7'" ~' 7 7' I
Resident: ~ ~: Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connecNons
and does not imnlv the structure meets all Citv Codes.
~~~.,~ ,~~45 /~,v .,9,~.'Q -•-~,~-~~,-.--- ~----~,~-~~.~----~~--~~-. ~._._._.
. ~ ~- r~ , ~~ , ~ „ t~ ~ ~~~i ~:~r
White: Homeowner Yellow: City Pink: HRG