HomeMy WebLinkAboutSump Pump Inspection,~ .
A. BASEMENT (~Yes ~No SiJMP BASKET ~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BA~KET ~ Yes ~ No SUMP PUMP Q 0'~ 1~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes 1' 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 ~Outside
at Inspection: a Floar drain ~ Other
Prior to Inspection:
B.
C.
D.
NOTES:
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~Other
~ Water in basement ~ Previous system failed
ROOF LEADERS: ~Yes Q No DI5CHARGE: ~ Near O Away
YARD DRAINS a Ye~No WINDOW WELLS ~ Yes~ No
BEAVER SYSTEM ~ Ye~L.,._No
PROPERTIES WITH SUMP PUMPS
When does pump run? ~:F_all ~Summer
(check all that apply) How often does pump run? _
V~here does pump discharge to outside? ~ Front
2~pring ~ Winter
~ Back Q Side
SUMP PUMP SYSTEM: ~PASS 7 FAIL You have 30 days to 6ring your system into comp[iance with current
regulations. When you are ready for reinspection, ca[l 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? l~ Yes ~ No
Where is this location?
This area will need t~ fixed so the clear water discharges to the storm sewer system.
'11'f~'t A /~ _ _ . 7R f . -- • -
Inspector:
Resident: ,
Date:
Date:
Disclaimer: Tlfis 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
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(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seai. Skip to Part B of this form.)
Discharge Point ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: 17 Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
~ Home came with system ~ Response fo inspection program
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~ No
C. YARD DRAINS ~ Yes ~ No
BEAVER SYSTEM Q Yes ~ No
and why
~ Other
DISCHARGE: O Near ~ Away
WINDOW WELLS Q Yes a No
D. PROPERTIE5 WITH 5UMP PUMPS
When does pump run? Q" Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back L7 Side
~-----------•---
NOTES:~--~j'~ •~ S ~ .~~.l.S 7AL~ ~ ~~'cJ-•-•~~~ --•-- o ~~ ..f.S l.p C
SUMP PUMP SYSTEM: CV~PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, cal! 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes I~ No
Where is this location?
This area will need to ixe the cle a scharges to the storm sewer system.
Inspector: ~ ~ ~ Date: - ~-s- ~
Resident: _ ,~ ~.~. -- ~--, ~..- ~ Date: - / S '
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
A. BASEMENT U Yes ~ No SUMP BASKET Q 0 D 1 ~ 2 D 3 ~
WATER IN BASKET ~ Yes ~ No SUMP PUMP O 0 I~ 1~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CI5TERN ~ Yes Q No
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Inspection Form ,~;~~~ r
Name: /~/'~? ~ ~,~,'/C~.~t~..~ Da~ ~~"~" i~9 Tim~r~.m./p.m.
~(/~~ ~ /
-~ --~~ First In~sp_~e n t~ Second ~
Address:~~Q~ _..L,~~i~~.C/,~ ~,C'Gc/ .~~ Own: E~' R`ent~: ' Age of Home:~ (~
r ,,,./_ ~ '~ ~/ ~ ,,,,. , Residential: ~'" ~
Prior Lake, MN 5~ /~ Phone`:7~~ ~~~~ Non-ResidentiaL• Q
~,,..Ul~c,/ ~ !G ~:; • ~ ~,/
A. BASEMENT es~__ O~ SUMP BASKET ~ 0 i~''/T ~ 2~ 3 ~
WATER IN BASKET ~Yes ~ No SUMP~~P~~~ ~ 0 t~' 1 O 2~ ~~,,~~
WATER IN BASEMENT (flow aver floor) ~ Yes L~ N o CISTERN ~ Yes C~ N a
(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 t] Other
Prior to Inspection: U~ 3c~ r1 ~-~
When was system installed, or most recently modified? (Date) ~ ~s ~~ and why
L7 e came with system O Response to inspection program ~ Other
~n baseme L'7 Prev' s s stem failed
Y
t1`
B. ROOF LEADERSc':, P~~~ es ~ No. DISCHARGE: ~ Near ~
C. YARD DRAINS ~ Yes L~7 N~'~ WINDOW WELLS ~ Yes ~
BEAVER SYSTEM ~ Yes [~''No
D. PROPERTIES WITH SUMP PUMPS ~/~~
When does pump run? ~ Fall ~ Summer CJ Spring ~ Wint
(check all that apply) How often does pump run? 7~E~ EA~ ?f ~~ 1~
Where does pump discharge to outside? ~ Front ~ Back e
NOTES: . ~ ~~ ~~S~ ~ ~G( "~.5~ D~-•-•---•-•-----•-•-------•-•-•---•-•---•-----•-•-•- -
SUMP PUMP SY5TEM: ~ PASS Q" FAIL You have 30 days to brin your system into co liance with current
regulations. When you are ready for reinspect~on, call 651/644-146$~for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~~ Yes _._ --'" ~~~
Where is this location?
This area will need to be ~Red s~the clear vyater~charges to the storm sewer system.
I Inspector: • -%?,~'~~~-' "'"`-------' Date: .~ -.-~'y = y' I
Resident: ~ ,~~ :> ' Date: ~
Disclaimer: Th~s visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all Cit_y Codes.
White: Homeowner
~~
e'- C'
, ~
` City of Prior Lake
Sump Pump and I/I Reduction
Yellow: City
Pink: ' HRG