HomeMy WebLinkAboutSump Pump Inspection~ . - ~ "` ~~ ~ ~'' C~
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A. BASEMENT O Yes ~No 5UMP BA5KET 0~ 1 ~ 2 ~ 3 O
WATER IN BASKET Q Yes Q No S UMP 0 O 1 ~ 2 3~
WATER IN BASEMENT (flow over floor) ~ Yes o CI5TERN ~ 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: 17 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 ~ Other
~ Water in basement D Previous system failed
B.
C.
D.
ROOF LEADER5: ~ Yes~l No DISCHARGE: ~ Near ~ Away
YARD DRAINS Q Yes No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM I~ 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 c~ischarge to outside? 17 Front Q Back
NOTES: ~---•- -•-•-! ~./1,/'~....
~ Winter
~ Side
SUMP PUMP SYSTEM: ~7 PASS ~ FAIL You have 30 days to bring your system into comp[iance 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? 17 Yes ~ No ~
Where is this location? ~
This area wil ee~l be so the clear w~at~er di charg to the storm sewer sry~stem. ~_
Inspector: V''~---'c~'. Date:
Resident: ~' Date:
Disclaimer: This visual inspection is done with due diligence to f'~nd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG
' ~ ~ j~ l
~' Y ~ ~ t,~,~.{.! {G/~..~
~~ r ~
A. BASEMENT ~ Yes~,No SUMP BA5KET 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET Yes ~ No S P P 0~ 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) I~ 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 O 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 Q Response to inspection program ~ Other
~ O Water in basement Q Previous system failed
B. ROOF LEADERS: Q Yes,~No DISCHARGE: ~ Near Q Away
C. YARD DRAINS ~ Yes No WINDOW WELLS O Yes Q No
BEAVER SYSTEM L7 Yes No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer 17 Spring
(check all that apply) How often does pump run?
Where doe pump discharge to outside~ ~ Front ~ Back
NOTES: ~---' ~/7/?.~~..,I' o ~ //~.~69 ~ ~~ `~~~v~
Q Side
SUMP PUMP SYSTEM: ~S ~ FAIL You have 30 days to bring your system into comp[iance with current
regulations. When you are ready jor reinspection, ca[I 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,ue.e~q be f,~aqed so the clear water,,,d~' charges to the storm sewer system.
Resident:
Q Winter
Date: _~
Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connecfions
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG
City of Prior Lake
~.. „~~/ ,
Name: ~~= ~~ J ~'~ ~?.;. ~ ~ Dat~ ~ ~ Time:~J"~Q~.m./p.m.
~ ~" ~~ C /First In~spe~c,t1'on ~ Second ~
Address:/~ ~~~ ,y"~'~/~'I ~/~//V~ ~~ Own: ~ Rent: ~ Age of Home: Q~
~j ~/,/ Residential: Q~'~~
Prior I~ake, MN 55 :~?/~ Phone:~7'Y~ i~'~~'~ Non-Residential: ~
Inspection Form ~,~,~J~
A. BA5EMENT I~''~es ~ No SiJMP BASKE ~ 0 Q 2 O 3 Q
WATER IN BASKET ~ Yes o SUMP P ~ 1 ~ 2 ~~'f]
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes ~~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 Q Laundry tub ~ Sanita.ry sewer ~ Outside
at Inspection: 17 Floor drain ~ Other ~'"~
Prior to I ction: ""~
When as systern installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement Q Previous sys failed
B. ROOF LEADERS: ~ Yes ~N~ DISCHARGE: ~ Near ~ Awa
Y
G YARD DRAINS Q Yes ~ WINDOW WELi.S ~~ Yes D-~o
R Y TEM ~ Yes N~~
BEAVE S S
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? ~^
V~here does numn dischar¢e to outside? ~ Front ~ Back Q Side
NOTES:
SUMP PUMP SYSTEM: I~'ASS ~ FAIL You have 30 days to bring your system into compliance with curr
regulations. When you are ready, jor reinspection, cal[ 651 /644-1469 for an aument.
Is there another place where clear water enters the sanitary sewer system? Q Yes No
Where is this location?
This area will need to ixe,~~b the cle~ wa~ischarges to the storm sewer system.
I Inspector: ~~'~ ~~'~-~'"c.c-```"~~'~`"'"~-~.- Date: ...~ -.C - 7 7 I
Resident: ~ _ ~.~ G'a-~-~-~--, Date: -,,2 - ~ y
.,
Sump Pump and I/I Reduction
Disclaimer: This visual inspect'on 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