HomeMy WebLinkAboutSump Pump Inspection~~
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name: ~~ ~.~ ~~~~~~r~~
~~
Address: ~~~~~~~'~~~~~~ ~~
~ ' ~~o -ro/~,~
Prior Lake, MN 55 ~/~ Phone:
,%~~P, ~"
Date:~J `~~ ~~Time,!/~~a.m./p.m.
First In~_sp~e ' n ~'" Second ~
Own: ~" Rent: ~ ge of Home: ~
Residential: ~ ~
Non-Residential: ~
A. BASEMENT ~LXe's ~,DT~' SUMP BASKET ~ 0~,,~'T ~ 2 ~ 3 ~
WATER IN BASKET I~es ~ No SiJMP ~P~ ~0 O 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes I~'No CISTERN ~ Yes ~
(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 l~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other
/~-
k
B.
C.
D.
Prior to Inspection:
When wa tem installed, or most recently modified? (Date) and why
ome came with system ~ Response to inspection program O Other
~ Water in basement ~ Prev' s system failed
ROOF LEADERS: ~~ es No DISCHARGE: ~ Near L9''Away
~~ ~~.~
YARD DRAINS~~~r~v es WINDOW WELLS ~ Yes L~'"No
BEAVER SYST~EM~~~ ~ ~ ~ Yes o
A
PROPERTIES WITH SUMP PUMPS
When does pump run? 17 Fall ~ Summer ~ Spring
(check all that apply) How often does pump run? ---'~
Where does pump discharge to outside? ~ Front Q Back
~ Side
NOTE5:
SUMP PUMP SYSTEM: 19'PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca11651/644-1469 for an app ' era.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b~~e clear v~nter~charges to the storm sewer system. _
( Inspector: ~ ~u~"" ~-~''' Date: .:~ - ~v ' 77 I
Resident: ~ , .,,,.~ ,, Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not impl_y the structure meets all City Codes.
White: Homeowner
Yellow: City
~ Winter
Pink: HRG
yyy~~~ ~ ~ ~ . . . . ...
~ i i _..~ ~~ 4... ~ '~.l ~ ~ .
~~ `-~
(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 a 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 ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes~ No DISCHARGE: ~ Near ~ Away
C. YARD DRAIN5 ~ Yes ~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM 17 Yes ~]' No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer L~ Spring Q Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
_ r'_'_'_'_'_'_' '_'3,~_'_'_'_'_'_'_'_'_
NOTES: ~HL~. l~/ 1~ 1~~SOtJE,----/S 'l^f~~ N@~ iE '--~ASSEt~
t 1 T7 ~ o~.,~~~~ QO i'c~' / S /4- ~~DT~ -' ~LE~IsaG C't~~eRE"c-r- //~~ S'ys7F_ ^~
SUMP PUMP SYSTEM: ~ PASS t~ FAIL You have 30 days to bring your system irtto compliance with current
regulations. When you are ready Jor 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 locaf ?
This area will ed Xo be fi}ged so the clear water dis~r~,es to the storm sewer system.
I Inspector: Date: 7-p(.~"'y' ~ 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
A. BASEMENT ~ Yes ~ No SUMP BASKET 0~ 1 L7 2~ 3 ~
WATER IN BASKET ~ Yes ~ No SUM~iJMP 0~ 1 ~~~ 3~
WATER IN BASEMENT (flow over floor) ~ Yes o CIS ERN ~ Yes No