HomeMy WebLinkAboutSump Pump Inspection~ .
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A. BASEMENT ;',~Yes ~ No SUMP BASKET ~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET 17 Yes ~ No SUMP PUMP ~ 0 1 17 2~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~No CISTERN ~ Yes C] 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 D Laundry tub ~ Sanitary sewer ~Outside
at Inspection: a Floor drain O Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
/y~ Home came with system ~ Response to inspection program Q Other
~~~'Water in basement ~ Previous system failed
B. ROOF LEADER5: ~ Yes ~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes'~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? /~Fall Q Summer ~ Spring ~ Winter
(cheek all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~~ PASS ~ FAIL You have 30 days to bring your system into compliance with current
~~\ regulations. When you are ready for reinspection, ca11651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~ No
Where is this location?
This area will need~be fixed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: h' ~ '~~
~-
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
i,~ ,:t.
~«
B.
C.
D.
NOTES:
SUMP PUMP SYSTEM: ~ PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, cal[ 651/644-1 9 fo an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to be fix,gc,~so~qhe claar w er discharges to the storm sewer system. ~~
Inspector: ~ :,,;//~/ (~,.2s~~'Z` ~,/" Date:
Resident: ~~ , , .nn Date:
Disclaimer: This''visual inspectioxY is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all Citv Codes.
(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 installed, or most recently modified? (Date) , a and why
~ Home came with system
O Water in basement
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
~Response to inspection program ~ Other
~ Previous system failed
'~Yes ~ No DISCHARGE: O Near ~Away
~ Yes No WINDOW WELLS ~ Yes Q No
~ Yes No
PROPERTIES WITH SUMP PUMP5
When does pump run? ~ Fall C~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? I~ Front ack ~ Side
White: Homeowner Yellow: City Pink: HRG
A. BASEMENT '`~-Yes Q No SiJMP BA5KET ~ 0'~ 1~ 2 Q 3 ~
WATER IN BASKET ~es ~ No SUMP PiJMP ~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~No CISTERN ~ Yes ~ No
~ ~,. . .~.~, ~ ~, r~ -r ~
2 `'~'
,*_
City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: ~~l~hA'r~~?~'1 /f,oh.-,A S
Address: .s~ F'~ L{~ lQ y C~ r.
Prior Lake, MN 55 3 72 Phone:~/~7-Z 3,~ ~
Date: 3- ~',~ -~'-~'~ Time2 ~ 3 ~ a.mr,~:~
First Inspection t~'~Second ~
Own: I~''~Rent: Age of Home:
Residential: ~
Non-Residential: ~
A. BASEMENT t3~es a~1o 5iJMP BASKET Q 0 l~ ~ 2 CJ 3~
WATER IN BASKET [~'es ~ No SLTMP P P t7 0~'I/ O 2 l7 3~
L
WATER IN BASEMENT (flow over floor) ~ Yes ~ o CISTERN O Yes Q~o
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. Skip to PaR B of this form.) .
Discharge Point ~ Laundry tub Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
Q Home came with system
~ Water in basement
B. ROOF LEADER5:
C. YARD DRAINS
BEAVER SYSTEM
L7 Response to inspection program C) Other
~ Previous system failed
~Yes ~ No DISCHARGE: I~ Near ~ay
~ Yes G~' D~ WINDOW WELLS Ya'Yes ~ No
~ Yes ~' No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ SumrMer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front O Back O Side
NOTES: ~---._._._._. .~i~'.-•-Pl/G Pl PE A/RE~-r~N /NTo SA l~ L/ NE -•-•-•-----•---•-•------
SUMP PUMP SYSTEM: ~ PASS E~AIL You have 30 days to bring your system into compliance with current
r ladons. When you are ready for reinspection, caU 651 /644-1469 for an pointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes F~No
Where is this location? •'
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: Date: 3- -
Resident: ~ 'a--- Date: ~ - ~ ~
Disclaimer: This visual inspec~ion is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG