HomeMy WebLinkAboutSump Pump InspectionX
(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
a t Inspec tion: a F loor drain ~ O t her
Prior to Inspection:
When was system installed, or most recently modi~ed? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADER5: 1~ Yes d No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS Q Yes No WINDOW WELL5 ~ Yes~ No
BEAVER SYSTEM ~ Yes No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer I~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back O Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS O FAIL You have 30 days to bring your system into compliance with current
reguladons. 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 ~ No
Where is this location?
This area will nee o fi ed so the clear water discharges to the storm sewer system.
Inspector: Date:
Resident: ~ ~! Date:
Disclaimer: This visual inspe+Etion 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 . G
~ ~~
A. BASEMENT j~' Yes ~.No SUMP BA5KET ~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ No SUMP PUMP ~ 0 1~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes Q No CISTERN Q Yes ~ No
~! ~i~~~,
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r
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. 5kip to Part B of this form.)
Discharge Point G7 Laundry tub O Sanitary sewer ~ Outside
at Inspection: I~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system fa Response to inspection program ~ Other
~ Water in basement ~] Previous system failed
B. ROOF LEADERS: ta Yes ~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes ~ No WINDOW WELLS O Yes ~ No
BEAVER SYSTEM ~ Yes ~ No
D.
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run? _
V~here d s pump discharge to outside? a Front
_"_._._ s_. ~:~~~---~`' -- - -~------------------
~ Spring ~ Winter
NOTES: ~ N -~ L ~- ~~
O Back ~ Side
~/G---~~~,~-.
~ QGr 7S / .~ L=
SUMP PUMP SYSTEM: AS5 ~ FAIL You have 30 days to bring your system into compliance with cur~ent
regulations. When you are ready for ~einspection, cal! 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C~t'~o '
Where is this location?
This area will need t~ fi~ so the cl~ water discharges to the storm sewer system.
Inspector:
Resident:
Date:
Date:
Disclai~ner: This visaal inspection is done with due diligence to find obvious clear water cross-connections
and do~s not imulv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG
A. BASEMENT Q Yes ~ No SUMP BASKET ~ 0 ~ 1 ~ 2 Q 3 ~
WATER IN BASKET ~ Yes ~ No SiJMP PUMP ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN O Yes ~ No
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Ci~y~ of Pri~~~ Lake
Sump Pump and I/I Reduction
Insnection Form
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Name:(,,,~C~~t-~~?~~~~. /~~/~7,~'~'~ Date~~`~ ~~~ Time~f~/aa.m./p.m.
G~.~ ~ ~.--~
_-y--~'' , /~ First Ins~p,,e~ '~n[~ Second L7 /
Address:e~~~~ /~~~7~~~~V Own: ~' Rent: ~ Age of Home: /~
,~/,~/ ~y Residential: ~Y~ ~
Prior I~ake, MN 55 ~~~ Phone:7' 7~~/~~ Non-Residential: ~
A. BASEMENT es ~ No~ ~ SUMP BASKET ~ 0 2~ 3 O
WATER IN BASKET ~ Yes ~No SUMP P~~~ O 0 1 O 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes O'No 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 17 Laundry tub ~ Sanitary sewer O~ utside
at Inspection: a Floor drain ~ Other
Prior to Inspection:
When w ystem installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program Q Other
C. YARD DRAINS ~ Yes ~,~ WINDOW WELLS I~ Yes ~"No
BEAVER SYSTEM ~ Yes C~' NO
Q Water in basement D Pre ' s system failed
B. ROOF LEADERS: es ~ No DISCHAI;GE: ~ Near Away
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer ~ Spring ~ Vyinter
(check all that apply) How often does pump run? ,~pN ~~/~~4 ~`•~
V~here does pump discharge to outside? L7 Front ~ Back ~ Side
.---•---•-•-•-• - - •---•-•- - -•-•-• ----•-•-•---•-•-• •
.~ ~---•---•-
NOTES: ~ f'~ G~'~ / U C~i ~ 7SI t7C
SUMP PUMP SYSTEM: ~ PASS AIL You have 30 days to bring your system into compliance with currera
regulations. When you are ready jor reinspection, call 651 /644-1469 for an app ent.
, -..~.rm. -~
Is there another place where clear water enters the sanitary sewer system? Q Yes dL~O
Where is this location?
This area will need to b f ed s e clear wa~discl~s to the storm sewer system.
Inspector: % ~`~ ~----~' Date: ._..~ ' ~ -~ -
Resident: ,n,., _ Date: ._... ~ `
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner
Yellow: City
Pink: HRG