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
at Inspection:
~ Laundry tub ~ Sanitary sewer ~ Outside
C~ Floor drain ~ Other
Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
~ Home came with system ~Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: "4~ Yes ~ No DISCHARGE: t~ Near ~ Away
C. YARD DRAINS L7 Yes ~ No WINDOW WELLS O Yes`~ No
BEAVER 5YSTEM 17 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? Q Front ~ Back Q Side
NOTES: ~
SUMP PUMP SYSTEM: ~ PASS ~ FAIL You have 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, call~9 jor 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 to be fixed so the clear water discharges to the storm sewer system.
Resident:
Date:
Date:
Disclaimer: This visual inspection is done with due diiigence to find obvious ctear water cross-connections
and does not impl_y the structure meets all City Codes.
White: Homeowner Yellow: City ~~
A. BASEMENT ,~ Yes I~ No SUMP BASKET ~ 0 18~, 1~ 2 ~ 3 ~
WATER IN BASKET ,~ Yes 17 No SUMP PiJMF Q 0~ 1 ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes ~ No
i~ r ~~4
(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 D Sanitary sewer ~ Outside
at Inspection: Q Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~'~.~~ and why
Q Home came with system ~ Response to inspection program ~ Other
""~-~ ~ Water in basement ~Previous system failed
B. ROOF LEADER5: ~ Yes ~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAIN5 ~ Yes ~ No WINDOW WELi.S ~ Yes I~" No
BEAVER SYSTEM ~ Yes l~ No
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall I~ Summer ,~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front 17 Back ~ Side
_.~. 7
-~- -•-•---•--
NOTES: ~---•-•-•-•-~i ~~ ~~ ------c.-~ ~ -•-•C~~e~ ----- ~ ~ r,~ i~~ r~~ /( nl~c ~~ --~-•-' I~n ~,~..
~ ~ +(~ ~~ u~r C/l~` ~' Q~T~ '~" t3-l,~ S,v~ 1~'~-f'~ v-''~ 5,~~~`~
SUMP PUMP SYSTEM: ~( PASS ~ FAIL You have 30 days to bring your system into compliance 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? Q Yes ~ No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ,. ~+~- e r' (~ (1, y ~-"3 ~ 7 Date: '~ / d
Resident: < nE.{ ~y, fTs, ~~+ Date:
Disclaimerc 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 ~ 2 Q 3 O
WATER IN BASKET ~ Yes ~ No SiTMP PUMP ~ 0~ 1 O 2 l'~ 3~
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CI5TERN O Yes ,$1 No
, ~a _s,
. ~ ;;, 4~ ~,R jo~
~~ ~~ ~
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
r } Name: ~~ ~ ~ / ~ /~C'~~= ~- Date:'7~rc? " ~,~
~ ~ ,
;~~, ~
Time~~ ~~a. m. /p. m.
~ Q~ / "~b~~O~„ ~~ ~„~ First Inspe~ction l9' Second ~ ,,~n
.
Address: 7 ~~/ Own: L~'' Rent: ~ Age of Home:~~~
` ,~~ ~9~~ Residential: L~3'~
Prior L~ake, MN 55 ~~i~ Phone:Y Non-Residential: D
A. BASEMENT L~Yes ~,,AYo SLJMP BASKET ~ 0 l~1"~ 2~ 3 7
WATER IN BASKET ~'~es ~ No SiJMP~~~TMp/ ~ 0 ~~ 2~ ~
WATER IN BASEMENT (flow over floor) ~ Yes do CISTERN ~ Yes o
(If no pump, place sticker across edge of sump eover;and basement floor so any removal of cover will
break seal. Skip to Part B of this form.) "
Discharge Point I~ Laundry tub ~ Sanitary sewer C9~'Outside
at Inspection: Q Floor drain ~ Other
B.
C.
Prior to Inspection:
When was system installed, or most rec y modified? (Date) ~~ ~~ and why
Q Home came with system Response to inspection program ~ Other
~ Water in basement ~ Previ system failed
ROOF LEADER5: es ~ No DISCHARGE: ~ Near ~ 4~way
D. PROPERTIES WITH SUMP PUMPS ~/
When does pump run? ~ Fall C9~Summer S ~ri~g ~ Winter
(check all that apply) How often does pump run? ~7~c-~ ~i9/ rJ
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES ~-~ ~ig.S C.,: G. ~~f~-•-•_..~~_~.~-~ 5-•-•.dr-~~------~,,,~--U 7 S~O L-"-•-•---•-•-
/ G( ( o
SUMP PUMP SYSTEM: ~ PASS FAIL You have 30 days to brutg your system into comp[iance with current
regu[ations. When you are ready for reinspection, cal[ 651/644-1469 for an pointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes Q'No
Where is this location?
This area will need to be ed s clear er arges to the storm sewer system.
Inspector: ' ~'~'~' Date: ' ~
Resident: ~ .. , ,: ' ~71 ~. , Date: ~ __
Disclaimer: This visual inspection is done with due diligence to f"ind obvious clear water cross-connections
and does not imply the structure meets all City Codes.
YARD DRAINS ~ Yes I~~''N~/o WINDOW WELLS ~ Yes ~
BEAVER SYSTEM ~ Yes C9~No '
White: Homeowner Yellow: City Pink: HRG