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.)
B.
C.
D.
Discharge Point
at Inspection:
~ Laundry tub ~ Sanitary sewer ~' Outside
D Floor drain 7 Other
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[[ 86A~/6~4+~69 for an aPpointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ,~ No
Where is this location?
~l nis area wi11 neect t, be rixea so tne ciear water aiscnarges to tne storm sewer syscem.
Inspector: Date: ~
Resident: -~'2''~., Date: 3 ~ ~
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.
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~ ~j and why
~ Home came with system y'~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
ROOF LEADERS:
YARD bRAINS
BEAVER SYSTEM
~ Yes Q No DISCHARGE: ~ Near O Away
~ Yes ~ No WINDOW WELLS Q Yes Q No
~ Yes No
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? Q' '~j~
V~here does pump discharge to outside? Q Front Back ~ Side
White: Homeowner Yellow: City
A. BASEMENT ~ Yes ~ No SUMP BASKET ~ 0~ 1 d 2 Q 3 ~
WATER IN BASKET ~ Yes Q No SUMP PUMP ~ 0'd~ 1~ 2 a 3 O
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes ~ No
~ ':~
~
~~~
. , r-" _ ~. C~a _ .n ~
A. BASEMENT 1~ Yes ~ No 5iJMP BASKET ~ 0 1 a 2 Q 3 ~
WATER IN BASKET ~ Yes ~ No SLJMP PUMP ~ 0 1~ 2 D 3 ~
WATER IN BASEME T(flow over floor) ~ Yes ~No CISTE ~ Yes~ T To
(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 L~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) I 5~ o and why
~ Home came with system ~ Response to inspection program Q Other
~i Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes t7 No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS Q Yes ~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM O Yes ~ No
D. PROPERTIES WITH SUMP PUMPS ~
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter '
(check all that apply) How often does pump run? I'~ a'f' 1( ~ct K O FT F ti1
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS L7 FAIL You have 30 days to bring your system into compliance with current
reguladons. 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 will need to be fixed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
D~te:
Date:
Disclaimer: This v.~sual inspection is done with due diligence to find obvious
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City
water cross-connections
Pink: HRG
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City of Prior Lake d dK° ~,x ~°;~ o~~
~c s smoti-. ~s poss~(s ,
Sump Pump and I/I Reductiori ~'"'` `n~~`~`;
Insuection Form ~,~~- i
Name: ~a ~~~' ~ e~~ (,~ f a~'"' Date~: ~~~ ~~~`~~ Time: ~ a.m p.m.
/ / ,~j First Inspection ~ Second ~
Address: ~`.> tt~~ ~:~ ..-.`~3 ~y r> t~~' /~VE N~~ Own: ~ Rent: ~ Age of Home:~
Residential~
Prior Lake, MN SS,j~ Phone: ~~p'~y~~ Non-Residential: I~
A. BASEMENT 1~Yes No SLJMP BASKET D 0 Q 2 ~ 3 ~
WATER IN BASKET „~Yes la No SUM PUMP ~ 0~ ~ ~2 3 O
WATER IN BASEMENT (flow over floor) ~ Yes ~No CISTERN [~ Yes/La 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
~ Home came with system ~ Response to inspection program Q Other
~ Water in basement Q Previous system failed
B. ROOF LEADERS: ~'Yes ~ No DISCHARGE: ~ Near ~Away
C. YARD DRAINS ~ Yes ~ No WINDOW WEL~.S ~ Yes ~ No
BEAVER 5YSTEM ~ Yes~No
D. PROPERTIES WITH SiJMP PUMPS
When does pump run? ~ Fall ~ Summer ~pring ~ Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front ~ Back O Side
NOTES:
c ~
SUMP PUMP SYSTEM: ~ PASS ~ FAIL You have`~i0 days to bring your system into compliance with current
regulat~ ns. When you are ready for reinspection, call 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 tR~lp~ f}~ec~so the ~le~r water discharges to the storm sewer system. ~ ~, ~,
Date:
Date:
~
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: Aomeowner Yellow: City' Pink: HRG