HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
Name: ~~fu~,', ~~~Y~N~~ ~- ~~ ~_~_~, ~P~~
Address: 1~I ~ 7~ r~G~~,rt ~~~~~
Prior Lake, MN 55~~ Phone: `~`l 7- ~.3 -7.3
Date:~- ~'~~ ~9 Time: /~~~~ a.m./p.m.
First Ins ction ~ Second ~1
Own: ~ Rent: ~ Age of Home: ~?~
Residential: L~'
Non-Residential: ~
. ~~ ~ L
A. BA EMENT ~Yes ~ No SiJMP BASKET L~'~0 ~ 1 ~ 2 O 3 ~
WATER IN BASKET I~ Yes ~ No SLTMP PUMP L~' 0 O 1 ~ 2 d 3 ~
WATER IN BA5EMENT (flow over floor) Q Yes ~'No CISTERN Cl Yes L~'~io
(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:
O Laundry tub '~ Sanitary sewer 17 Outside
O Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
17 Home came with system ~ Response to inspection program ~ Other
~ Water in basement C] Previous system failed
B. ROOF LEADERS: C~' Yes a No DISCHARGE: O Near L~' Away
C. YARD DRAINS ~ Yes C'~No WINDOW WELLS ~ Yes 13''~0
BEAVER SYSTEM ~ Yes i~''No
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? ~ Fall ~ 5ummer O Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front d Back
NOTES:
~ Side
SUMP PUMP SYSTEM: PAS5 I~ FAIL You have 30 days to bring your system into compliance with current
+~" regu[ations. 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 C-~ 1V o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~ ~( ~w Date: ~~- /6 ` 9
Residentf' Date: 6/- /~ - c/ f
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.
~ Winter
White: Homeowner Yellow: City Pink: HRG
:;
~, ~°~~_~~,~~~:~~~
' ~',-~'~.
A. BASEMENT ~ Yes ~No SiJMP BASKET 0~ 1 ~ 2 I~ 3~
WATER IN BASKET ~ Yes ~ No SUMP PUMP 0~ 1 ~ 2 I~ 3~
WATER IN BASEMENT (flow over floor) d 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 ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
a Home came with system ~ Response to inspection program ~ Other
O Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes No DISCHARGE: ~ Near a Away
C. YARD DRAINS ~ ~ Yes No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes No
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 pu discharge to outside? O Front O Back ~ Side
- -•-•---• ~}'~~~~ -s-• -•R•---- - -•-•-
NOTES: ~ ~~/ ~/V~^ ~ Y~ ''I...._'_~---~ •-•~~jSL.~ --
l
SUMP PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready jor reinspection, cal! 651/644-1469 for an appoirument.
Is there another place where clear water enters.the sanitary sewer system? Q Yes ~'No
Where is this location? ~
This area will~ to be~d so the clear w~r disch~xge~ to the storm sewer system_
~ ~
Inspector: ' Date:
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 C}ty Codes.
White: Homeowner Yellow: City Pink: HRG