HomeMy WebLinkAboutSump Pump Inspection~
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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, ca[l 9i~FlA~4~y6r appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes 6~ No
Where is this location?
This area will need to,~~xed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: /'7/ Q
Date: ~ /"~J ~
Disclaimer: ~l~is vis al inspection is done with due diligence to find obvious clear water cross-connections
and does not imn v the structure meets all Citv Codes.
White: Homeowner
(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 L1 Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection: ~ ~.-~~~~ ~ = '~~ q ~ ~
When was system installed, or most recently modrfi~~~ate) ~ t and why
~ Ho'hle came with system I~ Response to inspection program ~ Other
Q Water in basement ~ Previous system failed
ROOF LEADERS: ~ Yes ~ No ' DISCHARGE: 7 Near Q Away
YARD DRAINS + ~ Yes ~No WINDOW WELLS ~J Yes ~ No
BEAVER 5YSTEM ~ ~ Yes ~No
.~.~. ,,~°"
PROPERTIES WITH SUMP PUMPS
~ ~-_.
When does pump run? ~ Fall ~"Swnmer ~ Spring Q Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~Front Q Back ~ Side
~'~'~'~.~~~'~'~'~'~.~.~'~'~.~t'~.~.~.~.~'~'~.~'~'~'~.~'~.~'~'~.~'~'~.~'~'~'~.~.~'~'~.~.~.~'~'~'~.~.~.~'~.~'~'~'
Yellow: City
A. BASEMENT L~R"`Yes ~ No SUMP BASKET ~ 0 ~ t7 2~ 3 ~
WATER IN BASKET ~ Yes ~ No SUMP PUMP ~ 0 ~~'' 1~ 2 ~ 3 ~
WATER IN BA5EMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes I~•~o'-
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' City of Prior Lake
Sump Pump and I/I Reduction __
Insnection Form
L0.u r0~
Name: ~ ~~' ~(
Address: ~ ~ 6 ~ J /1 D~ ~i"~ /(~ ~
Prior Lake, MN 55~ Phone: ~96"/S~~
O Laundry tub ~ Sanitary sewer ~Outside
Q Floor drain O Other
A. BASEMENT ~ Yes ~ No SUMP BASKET Q 0 1~ 2 ~ 3 ~
WATER IN BASKET ~es Q No SUMP P P ~ 0~1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) Q Yes No CISTERN D 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:
B.
C.
~-~-
Date: ~~ ~~'9 Time:_~a.m~/~
First Inspection Q Second ,~
Own:.~. Re : Q Age of Home:~
Residential:~
Non-Residential: ~
Prior to Inspection: (~
When was system installed, or most recently modi~ed? (Date) ~ and why
~ Home came with system ~Response to inspection program ~ Other
O Water in basement ~ Previous system failed
ROOF LEADERS: ,[~-~es I~ No DI5CHARGE: Q Near .~Away
YARD DRAINS ~ Yes o WINDOW WELLS ~ Yes~No
BEAVER SYSTEM ~ Yes No ~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~3ummer ~Spring ~ Winter
(check all that ap~ly) How often do pump run?
V~here does pump discharge to outside? ~ Front l~ Back O Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS ~ FAIL You have 30 days to bring your system into compliunce with current
regulations. When you are ready for reinspection, ca[[ 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? O Yes No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: /- -
Date: ~ ~- i z-~
Disclaimer: This visu inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG
~~~ ~
A. BASEMENT 1~.Yes ~ No SUMP BASKET ~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET~Yes a No SITMP PITMP ~ 0;~ 1 I~ 2~ 3 ~
WATER IN BA5EMENT (flow over floor) ~ Yes ~No CISTERN ~I7 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: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why ~
O Home came with system ~ Response to inspection program ~ Other
~ Water in basement Q Previous system failed
B. ROOF LEADER5: ~ Yes Q No DI5CHARGE: ~ Near~ Away
C. YARD DRAINS ~ Yes~ No WINDOW WELLS Yes Q No
BEAVER SYSTEM Yes ~ ~ No ~
~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer Q S ring Winter
(check all that apply) How often does pump run? ~ --- ~oa, /Lc~1~~
Where does pump discharge to outside? ~ Front Back " Side
- r~ ~~~~~~~~~ -j_. -•---~-'`--- •- - - -- '
NOTES: ~!~ `t.~n.-(!~.~ ... ~ ~cn..4.,,.,-~~.,,~ ~.~ ~~ iLr~-c-±~ Q.~.c~~..--
5UMP PUMp SYSTEM: ~ PASS FAIL You have 30 days to bring your system into comp[iance with current
regu 3~ . When you are ready for reinspection, cal! 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 wil~~ed to be fixed so the clear water discharges to the storm sewer system.
Resident: ' ~.r > -- ~ ~ ~"-,~,e .s <~ <~ <
Date: l/-
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 Cit_y Codes.
White: Homeowner
Yellow: City
Pink: HRG