HomeMy WebLinkAboutSump Pump Inspection~~
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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 ~ Laundry tub ~ Sanitary sewer ~e
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~'J'«,~,~~ ~9~'~ and why
~ Home came with system ~ Response to inspection program ~ Other
Q Water in basement C~-~1'~vious system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near d Away
C. YARD DRAINS ~ Yes 17 No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ 5ummer ~ Spring ~ Winter
(check all that apply) How often does pump run? yl~rcir ~ ~~, v~ s
V~here does pump discharge to outside? ~ Front ~ Back Q~-3~t1~'
NOTES: ~---•-•- - ---- ~~ ~ --•-• ~V G -•- ~ ---~ ~ ~"~ -~ •~I P , --•-•-•---•-•---•---•-------•-•---•-•-•-•-----•-•-•-•-
SUMP PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulation.s. 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? Q Yes -~"'l~o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ! Date: ~ / ~ ~ `~
Resident: Date: ~- / ~ - 9 j
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 ~s a No SiJMP BA5KET a 0 ~~ 2 ~ 3 ~
WATER IN BASKET ~s ~ No SiJMP PUMP O 0 ~~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes .~"o CISTERN O Yes L~#Q
y.• . ..
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
Name: i~~~~ ~ ~ '~~
Address: ~~~~~ k~'~~'~~ ~V
Prior Lake, MN 55 ~~~ Phone~~~ i~~ ~
Date~%~~"~ Time,t~~~m./p.m.
First In~sp_e,c,~ ~' ~ Second ~ /
Own: LzY Rent: Age of Home: C~
Residential: ~ ~
Non-Residential: ~
A. BASEMENT ~'Yes~~ SUIV~ BASKET ~ 0 ~~ 3~
WATER IN BASKET es ~ No 5LTMP~~~~ ~ 0 1~ 2 ~ 3
WATER IN BASEMENT (flow over floor) ~ Yes o CI5TERN ~ Yes o
(If no pump, place sticker across edge of sump cov r and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point undry tub U Sanitary sewer Q Outside
at Inspection: ~ Floor drain ~ Other
Pjior to Inspection:
When was tem installed, or most recently modified? (Date) ~-
ome came with system Q Response to inspection program ~ Other
~ Water in basement ~ Previous syste iled
and why
B. ROOF LEADERS: ~ Yes o DISCHARGE: ~ Near O A ay
C. YARD DRAINS ~ Yes I~~~ N/o ~ WINDOW WELL5 t'~ Yes ~ No
BEAVER SYSTEM ~ Yes ~Qo
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall d Summer Q Spring Winter
(check all that apply) How often does pump run? J~/EV E'2 EA~.~ ! T
V~here does pump discharge to outside? ~ Front ~ Back Q Side
NOTES:._.-•---•~•CS--•-• ~ }A ~--•-• ~'-"-G ~„X /~OSE ~ ~i9 u /J~D2 +~
/~ l~ /~
~"~~ ~
Is there another place ;where clear water enters the sanitary sewer system? L~ Yes o
Where is this location?
This area will need to b xed e clear wa dis arges to the storm sewer system.
Inspector: Date: _ Z- Z S-
Resident: ~ r Date: Z- S-/
Disclaimer: This visual inspection is done with due dilige e to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
SUMP PUMP SYSTEM: ~ PASS C~-~IL You have 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, cai16511644-1469 for an tntment.
~
White: Homeowner
Yellow: City
Pink: HRG