HomeMy WebLinkAboutSump Pump Inspection, ~ ~ 1 ~ ~~+`~'k ~ ~ . .. . , .
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(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 C1 Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modi~ed? (Date) and why
17 Home came with system ~ Response to inspection program ~ Qther
Q Water in basement a Previous system failed
B. ROOF LEADERS: ~ Yes I~No DISCHARGE: Q Near ~ Away
G YARD DRAINS ~ Yes ~ No WINDOW WELI.S ~ Yes~ No
BEAVER SYSTEM ~ Yes ,~, No
D. PROPERTIES WITH SUMP PUMP5
When does pump run? ~ Fall ~ Summer 17 Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back O Side
~" NOTES:~---•-• j--~~iu~~G7~v1`''i --•-•-----•-•-•-------•--- - ---•---•-----•---------•-----------•-•-•---•-----•-
~
SUMP PUMP SYSTEM: ~PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready far reinspection, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? I~ Yes ,~~ No
Where is this location?
This area wi~2l~to ~Jfixed so the clear ate discharges 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 strueture meets all City Codes.
~
White: Homeowner
Yellow: City
Pink: HRG
A. BASEMENT O Yes ~No SiJMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BA5KET ~ Yes ~ No SUMP PUMP ~' 0~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~No CISTERN ~ Yes ~ No r;
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
Name:/ '/~,~~vt~i G`~~•~~~~
~~
Address:~'Y ~~ ~I~~~~1~0~'.~~ /!~
Prior Lake, MN 55~ /.~' Phone: ~`'~`~'~~~ g
~~~ J ~'
Date~ i~~ r~ Time~~~~a.m./p.m.
First In~s~ ion ~'" Second ~
Own: I~ Rent: Age of Home;~ ;
Residential: ~ ~
Non-Residential: ~
A. BASEMENT es ~ No~/ SUMP BASKET ~~~~ 1 Q 2 ~ 3 L7
WATER IN BASKET ~ Yes ~SNo SiJMP ~P~ 19' 0~ 1 ~ 2 ~~ 3 17
WATER IN BASEMENT (flow over floor) Q Yes C~' N o CISTERN ~ Yes 0" N 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 ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other ---
~
Prior to Inspection;
Whe was system installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Prev'ous system failed
B. ROOF LEADERS: n C 9~' Y e s ~ No DISCHARGE: ~ Near Q'' A w ay
~~~ ~ ~~~~
C. YARD DRAINS P U~- I°l Yes !~. N~'` WINDOW WELLS ~ Yes ~1~io
BEAVER SYSTEMQ y ~ Yes ~/NO
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? -~'"`~~
V~here does pump discharge to outside? I~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: I~'ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, cal! 651 /644-1469 for an intment.
Is there another lace where clear water enters the sanita sewer s stem? ~ Yes L~~'''No
A rY Y
Where is this location?
This area will need to ixed the cle w discharges to the storm sewer system.
/~ __ ~ _~i _- _
Inspector: < f'~"' Date: ~ -~~' '
Resident: ~ !.t ,~. /o . t~.., . ~„ , _/, _,,, 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 Pink: HRG