HomeMy WebLinkAboutSump Pump Inspection~~ ,~f ~t~~ Q
City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
A. BASEMENT la Yes ~ No SUMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes L~ No SUMP PUMP ~ 0 O 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) O 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 ~] Sanitary sewer ~ Outside
at Inspection: ~ Floor drain C7 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 Q No DI5CHARGE: Q Near ~ Away
C. YARD DRAIN5 ~ Yes ~ Now ~ WINDOW WELLS ~ Yes Q No
BEAVER SYSTEM 17 Yes ~ No
D. PROPERTIES WITH SUMP PUMP5
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
-•-•-•-•-•-•----- ---._._._._._._._._._.s. .-• -----~,-! -•~~--• •-•-•----
NOTES: _~°_ ~ A r^~- ~ ~ ~~/' ~.~C~.~t".~P y-- ~~'`Pr..,.) ~' r- _._._._._.-•-•-•-•-•-•-•-•-•-
SUMP PUMP SYSTEM: ~`PASS ~ FAIL You have 30 days to 6ring your system into compliance with current
s~~r 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 location?
This area will ed j e~c d so the clear w~r+~ischarges to the storm sewer system.
I Inspector: ~~''~ __ Date: x-a!_ 3-~' i' 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
~-x>'~l
?~/~4
(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
~ Home came with system
~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program ~ Other
~ Previous system failed
~ Yes O No DISCHARGE: O Near ~ Away
~ Yes ~ No WINDOW WELLS ~ Yes ~ 1~To
la 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? ~ Front ~ Back O Side
- -•~•-•-•-•-•-
NOTES:'- ~--~-~~y ~~'~P~ s /',~ f !-- -.-----•-•---•-•-•-•-•-•-•-------•---------•-•-•-•-•-•---•-•-----•---•-•-
l6~'
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance wuh current
regulations. When you are ready for reinspectian, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~ No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: Date: 2 /G- 9~J
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 XeLlow: ' City Pink: HRG
A. BA5EMENT ~ Yes O No SiJMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ No SUMP PUMP ~ 0 ~ 1 ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) Q Yes Q No CISTERN ~ Yes ~ No