HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
/~~PJT"
Name: ` ~~~~ ~~~~ Date:~"~r ~~ Time:~~~~.m./p.m.
,~/ ~ First In~spe~ct''on ~cond ~
Address: " Y~~~ ~~''L d~~'~'C ~~~ ~'~Own: ~ Rent: ~ Age of Home;,~~
/ ,/ Res~~enti~l: IT~'~~ ~
~ '~~~ ro~"~c~
Prior Lake, MN 55 ~~~ Phone:~ Non-Residential: ~
C. YARD DRAINS ~ Yes O~~~1V'` WINDOW WELLS ~ Yes ~
BEAVER SYSTEM ~ Yes L~No
D. PROPERTIES WITH SUMP PUMPS -
When does pump run? O Fall Q Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
Wthere does pump discharge to outside? Q Front ~ Bac'~C' ~ Side
NOTES:
A. BASEMENT ~s ~ No~ / SUMP BASKET I~_~0 1~ 2 ~ 3 O
WATER IN BASKET ~ Yes @~No SiJMP P~IJM~~ ~ D 1 ~ 2~ ~~'" ~
WATER IN BASEMENT (flow over flpQr) ~ Yes ~~o CISTERN ~ Yes L'~YRo
(If no pump, place sticker across edge of sutnp cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point ~ Laundry tub ~7 Sanitary sewer r.-- ~ Outside
at Inspection: Q 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 O Other
Q Water in basement ~ Pre 'ous system failed
B. ROOF LEADERS: L9'Yes la No DISCHARGE: ~ Near ~way
SUMP PUMP SYSTEM: ~ASS 17 FAIL You have 30 days to bring your system into compliance with current
regulations. 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 CtYi~o
Where is this location?
This area will need to b,~ixe~so the cleaywater discharges to the storm sewer system.
Inspector:
Resident:
Date. y-
Date: - •
Disclaimer: This vis~ual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner
Yellow: City
Pink: HRG
~ ~~~~> ~ ~-~:-~~~ ~
A. BASEMENT L~ Yes ~Aio 5UMP BA5KET 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes a No SIJMP PI7MP 0 O 1 Q 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~No CISTERN ~ 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 I~ Outside
at Inspection: Q Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Horne came with system ~ Response to inspection program ~ Other
Q Water in basement Q Previous system failed
B.
C.
D.
BEAVER SYSTEM ~ Yes No
ROOF LEADERS: ~ Yes ~No DISCHARGE: Q Near Q Away
YARD DRAINS ~ Yes No WINDOW WELi.S ~ Yes ~ No
PROPERTIES WITH SUMP PUMPS
When does pump run? 17 Fall ~ Summer ~ Spring
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back
NOTES: 1 1l~t.a~ ~~-•-• 4 Q"~',- •-•-- S~~ ~SOIj d 03~ o.
~ Winter
~ 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, cal! 6571644-1468 for an appointment.
Is there another place where clear water enters the sanitary sewer system? I~ Yes ~ No
Where is this location?
This area wil~,~e~d to b~'ixed so the clear vy,~r discharges to the storm sewer system.
...~r.,,,,~
Resident:
Date: d" ~
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
~ `h y ~ ~ ~
~,-~ '. ~'~ ~i t_1 {[7~ ; _,,, c_.7~.
~11aU ~~'~ ~~p ~+r~..~~
A. BASEMENT ~ Yes ~No SiJMP BA5KET ~ 0 ~ 1 ~ 2 O 3 O
WATER IN BA5KET ~ Yes ~ No SiJMP PUMP a 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BA5EMENT (flow over floor) ~ Yes~ No CISTERN ~ 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 I~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: Q Floor drain ~ Other
Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
~ Home came with system I~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~No DISCHARGE: C7 Near ~ Away
C.
D.
YARD DRAINS Q Yes No WINDOW WELLS
BEAVER SY5TEM ~ Yes No
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back
._._._.-•-•-•-•-- • -----•-•-•-•-• •- --
•-------
} -------•-•-- i
NOTES: 1 ~} [' u_ -., ~_ "'_"' €~~ ~i ~~ ; ~- D -~---`----------
~ Side
SUMP PUMP SYSTEM: ~ PASS O FAIL You have 30 days to bring your system into comp[iance with current
regutations. 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 ed be filr~e,d so the clear water di~ges to the storm sewer system.
Inspector:
Resident:
C~ Yes a No
~ Winter
Date: `y / ,3' ~
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 Cades.
White: Homeowner Yellow: City Pink: HRG