HomeMy WebLinkAboutSump Pump Inspection,_ ,
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A. BASEMENT ~ Yes ~No SUMP BASKET ~ 0 ~ 1 ~ 2 O 3 ~
WATER IN BASKET ~ Y s ~ No SiTMP PUMP 0~ 1 ~ 2 ~ 3 O
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 Q Laundry tub C] Sanitary sewer ~ 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 ~ Previous system failed
B. ROOF LEADERSc [~ Yes L~No DISCHARGEc (a Near ~ Away
C. YARD DRAINS ~ Yes j~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM 17 Yes ~ No
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? t7 Fall a Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front d Back ~ Side
NOTES:
SUMP PUIVIP SYSTEM: ~ PASS ~ FAIL You have 30 days to bring your system into complfance 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 ~ No
Where is this locatiom?
This area will need to be fa~ed so the clear wa~discharges to the storm sewer system.
I Inspector: ( ~/' ~~ ~,,,~,~''~j~f~,._-.~,^! Date: '~,.~S=7Z I
Resident: ~~ 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
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A. BASEMENT ~ Yes ~,No SUMP BASKET ~ 0 d 1 ~ 2 17 3~
WATER IN BASKET ~ Yes ~ No SUMP PUMP ~1 0 O 1 ~ 2 a 3 ~
WATER IN BASEMENT (flow over floor) a Yes ~1 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 ~ Laundr}~ tub 17 Sanitary sewer Q Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or m:ost recently modified? (Date) and why
~ Home came with system
~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER 5YSTEM
~ Response to inspection program ~ Other
Q Previous system failed
a Yes~ No DISCHARGE: ~ Near ~ Away
~ Yes~.l No WINDOW WELLS ~ Yes ~ No
~] Yes ~ No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ 5ummer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back O Side
NOTES: ~L[.~/'~ S--•-• ,.~•--~~-~-5-------•---•-•---•-•-•-•---•-•---•-•---•---•-•---•-----•-•-----•-----•---•-•-
~ G~
SUMP PUMP SYSTEM: ~ PASS C1 FAIL You have 30 days to bring your system into compliance with currenl
regulat~ons. 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? 17 Yes ~ No
Where is this location?
This area w' need b d so the cleaf water~,d si'~harges to the storm sewer system. _
~
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 Pink: HRG
1~4.
~ ~ ~
~ ~ ~ ~~ pRf O~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,,~~,~Jr
o~~
Name: fi'~~'~,~.'/-~O~C,/~ ~~'~~i'~,S' ~ ate: -~c~-~~ Time;,~~•3~a.mJp.m.
/ ~( `' ' / First Ins~ ion ~ Second Q
Address:~~~~~N~~~s 6~ 7~'~ Own: L'1 Rent: ~ Age of Home:.~0
//,/ Residential: L9''~ ~
Prior Lake, MN 55 ~~i~/ Phone~ YY~"~1 ~~ Non-Residential: ~
A. BASEMENT~y DXes ~ No~ SUMP BASKET ~~ 1~ 2 Q 3 ~
WATER IN BASKET ~ Yes o SiTMP PTJ~P 0~ 1 ~ 2~ ~
WATER IN BASEMENT (flow over floor) O Yes 13~1~io CISTERN d 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
at Inspection:
~ Laundry tub O Sanitary sewer O Outside
~ Floor drain ~ Other `'~
Prior to Inspection:
When was system installed, or most recently modified? (Date)
L7 Home came with system
I~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program
~ Previous sy em failed
C~~T
.~-'.
t7 Other
and why
Ca Yes o DISCHARGE: ~ Near O Away
a Yes WINDOW WELLS I~ Yes ~"No
I~ Yes o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
~ Spring ~ Winter
.---
~ Back --" Q Side
SUMP PUMP SYSTEM: I~PASS a FAIL You have 30 days to bring your system into complionce with current
regulations. When you are ready for reinspection, ca[[ 651/644-14&9 for an irument.
Is there another place where clear water enters the sanitary sewer system? ~ Yes m/No
Where is this location?
This area will need to be ~e clear v~aater~arges to the storm sewer system.
Inspector: ~ ~ .!~~'~ ~--' Date: /~%~~"%
Resident: , f~-,, _ ~ 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