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 O Outside
at Inspection: d Floor drain d Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
U Water in basement O Previous system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes a No WINDOW WELLS ~ Yes Q 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 O Back ~ Side
~ f~ -•- - - ~ -• - --•-•-•--- - - - - -
NOTES: Gl.,.~ /. S'~-~ i"") .."" o.% D~l ~ rT y~' -•-•---•-•
ct~,~ i ~ ~ pr~ ...I"<!c~ /2
SUMP PUMP SYSTEM: ~ PASS I~ FAIL You have 30 days to bring your system into compliance wiih current
''\__ regulations. When you are ready for reinspection, call 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~o
Where is this location?
This area ~Y''nee be fi~ so the clear water disch~s,~o the storm sewer system.
...~Y.,.,~.,..
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
A. BASEMENT ~ Yes ~ No SUMP BASKET ~ 0 ~ 1 Q 2 O 3 ~
WATER IN BASKET I~ Yes 17 No SUMP PUMP ~ 0 ~ 1 ~ 2 17 3~
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes ~ No
G,~ ~r~~ ~ l~ s c~
A. BASEMENT ~ Yes ~No SUMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET I~ Yes ~ No SL1MP PUMP
~'0 Q 1 I~ 2 D 3 Q
,
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CI5TERN a Yes ~To
(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 I~ Outside
a~ Inspection: Q Floor drain O Other
Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
~ Home came with system Q Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes No DISCHARGE: Q Near Q Away
C. YARD DRAINS I~ Yes No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? D Fall Q Summer ~ Spring ~ Winter
(check all that pply) How often does pump run?
V~here does mp discharge to outside? O Front a Back ~ Side
~---•- - - - - - - -•--- - - - - - - - - -•-•--
%~~ ~- - -•-•---•-•---•-•----- - -•-•-
NOTES:
7C,,J
SUMP PUMP SYSTEM: ,1~9.~ASS ~ FAIL You have 30 days to bring your system into compliance with current
l reguladons. 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 ,~No
Where is this locat' n?
This area will e~ to e e so the clear water dis ar s to the storm sewer system.
Inspector: Date:
Resident: 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
`
~s
A. BASEMENT ~s~ 5UMP BASKET ~ 0 ~ 2 ~ 3 ~
WATER IN BASKET es ~ No SiJMP PUMP, ~ 1 ~ 2 Q 3 ~
WATER IN BASEMENT (.flow over floor) ~ Yes ~~ 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: I~ Floar drain ~ Other
Prior to Inspection: i
When was system installed, or most recently modi~ed? (Date) and why
Lol Home came with system 17 Response to inspection program ~ Other
O Water in basement 17 Previ system failed
B. ROOF LEADERS: ~No DISCHARGE: ~ Near Q~'"way
C. YARD DRAINS ~ Yes L-iYN/o ~' WINDOW WELLS Q Yes `A""No
BEAVER SYSTEM D Yes ~'ftO
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall ~ Summer 17 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 Q FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 6511644-1469 jor an appointment.
Is there another pl~ce where clear water enters the sanitary sewer system? ~ Yes f9'No
Where is this location?
This area will need to ix s the clear at discharges to the storm sewer system.
Inspector:.,,~~ •
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.
Date: ..3-1 S -
Date: ~
White: Homeowner
Yellow•: City
Pink: HRG