HomeMy WebLinkAboutSump Pump Inspection~
A. BASEMENT ~Yes ~ No SUMP BASKET L7 0 1~ 2 ~ 3 ~
WATER IN BA KET ~ Yes ~ No SUMP PUMP ~ 0 a 1 ~ 2 ~ 3 17
WATER IN BASEMENT (flow over floor) ~ Yes ~I No CISTE O 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
at Inspection:
~ Laundry tub ~ Sanitary sewer a Outside
~ Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~(,X a'and why
Q Home came with system ~, Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: ~ Near Q Away
C. YARD DRAIN5 ~ Yes No WINDOW WELLS ~ Yes a No
BEAVER SYSTEM 17 Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~' 5pring L~ Winter
(check all that apply) How often does pump run? ~~( ~ ~-'~...
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS 17 FAIL You have 30 days to bring your system into comp[iance with current
regulations. When you are ready for reinspection, ca[I &64~9~M~4~Y9 for 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 fixed so the clear water discharges to the storm sewer system.
Inspector: Date: ~ O
Resident: Date:
Disclaimer: This visual inspection is done with due diligence to fmd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City
(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 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: ~' Yes Q No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes l~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes ~(, No
D.
NOTES:
PROPERTIES WITH SUMP PUMPS
When does pump run? D Fall ' ~ Summer ` ~~- S,~,~rin,g ~ Winter
(check all that apply) How often does pump run? NG ~~ :'~
V~here does pump discharge to outside? l~ Front Q Back ~ Side
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? ~ Yes ~ No
Where is this location?
This area will need to be fi~ed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: ~
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 ~~~",~'++.
A. BASEMENT ~ Yes ~ No SUMP BASKET O 0~ 1 ~ 2 Q 3 Q
WATER IN BASKET ~ Yes ~ No SUMP PUMP O 0~ 1 Q 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes Q No CISTERN 17 Yes ~ No
~ ~ ~ ~~ PRtp~ ; . . .
~,~ ~. ,f~
~ ~ ~ ~ ~~
~~
~° _~
~
~ ? ~,., .
City oaf Prior Lake
Sump ~ Pump and I/I Reduction
ection Form
_..,~ ~ ~-~~,~ ~ ~ ,~~,r ~t ~- ~-~,,~ ~~ e Date: -~ 2 `/ ~ ~ 9 Time: ~ v oa.m./p.m.
Name: ~
First Inspection ~Second ~
Address: 1 ~? i~ ~> ~ i 1~.~ 4,~ ~/, fU ~ Own: O' Rent: U Age of Home: /~/
Residential: L~
Prior Lake, MN 55~~ Phone: t/ ~7- ~~~1 ~ Non-Residential: O
~,,,o / ,~~, ~~
A. BASEMENT L~'~es ~ No SUMP BASKET ~ 0 C~'~. ~ 2 ~ 3 ~
W~TER IN BASKET ~s ~ No SUMP PIIMP O 0 I~~ 1~ 2 ~ 3 ~
Wl~fTER IN BASEMENT (flow over floor) ~ Yes l3#o CI5TERN C~ Yes L#~'G~o
(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:
Prior to Inspection:
When was system installed, or most recently modified? (Date)
~' Home came with system ~ Response to inspection program
~ Water in basement ~ Previous system failed
~ Other
and why
B. ROOF LEADERS: ~~ No DISCHARGE: I~ Near ^i Away
C. YARD DRAINS ~ Yes C'~No WINDOW WELLS O Yes ~''1Go
BEAVER SYSTEM ~ Yes ~' No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall I~u~mmer ~ring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ PAS5 AIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[l 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes A~~o
Where is this location?
This area will need to be fixed so the clear water discharges tq the storm sewer system.
Inspector: Date: ~- 2~/- g 9
Resident: ' Date: ~ ,,.~ ~/- yy
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.
°b
White: Homeowner Yellow: City
Q Laundry tub C-t'Sanitary sewer Q Outside
O Floor drain Q Other
Pink: HRG