HomeMy WebLinkAboutSump Pump Inspectionr~. :
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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 ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: a 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 Q Previous system failed
B. ROOF LEADERS: d Yes~No DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall O Summer Q Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back O Side
NOTES: ~-----•-~L.t~/1fS G~( T ~da7"` S--- ~---•; 1- C--•-• ~~~-----•-•-
G' ! ------•---•-•-•-•
SUMP PUMP SYSTEM: ~PASS I~ FAIL You have 30 days to bring your system into compliance 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 location?
This area ' ne to fixed so the clear ate discharges to the storm sewer system.
Inspect . -- 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 City Codes.
White: Homeowner Yellow: City Pink: HRG
A. BASEMENT ~ Yes ~AIQ SiJMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ No SiTMP PUMP 0~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) O Yes d No CIS RN O Yes a No
~ ~ d •a~3<:~%~'~~C>
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City of Prior Lake
Sump Pump and I/I Reduction
ion Form
Name: ~~.`-' l~.lf.~i'i r' ~J-~t7rc~
Address: ~/b ~7 /f~ ~~ G1 i' :
Prior Lake, MN 55 ; 7,Z Phone: ~,lO - Z ~/$"
First Inspection ~' Second ~
Own: I~"" Rent: Q Age of Home:
Residential: L~'~
Non-Residential: ~
A. BASEMENT ~"Yes ~ No SiJMP BASKET ~' 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET a Yes la'l~o SUMP PIJMP ~~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes l~o CIS1'ERN ~ 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
at Inspection:
~ Laundry tub ~ Sanitary sewer I~ Outside
O Floor drain d Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
L~ Home came with system
O Water in basement
C. YARD DRAINS
~ BEAVER SYSTEM
B. ROOF LEADERS:
and why
~ Response to inspection program ~ Other
Q Previous system failed
~ Yes QYNo DISCHARGE: ~ Near ~ Away
~ Yes L'~4~'~~1 WINDOW WELLS ~ Yes4~''No
~ Yes ~''No
D. PROPERTIES WITH STJMP 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 ~ Side
NOTES:
Inspector: Date: 3-3~ 99
Resident: Date: ~ ~,,,~ S-~
SUMP PUMP SYSTEM: ~SS ~ FAIL You have 30 days to bring your system into compliance 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 ~-o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
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
Date: 3- 3 - `~°/
Time: //.'15~1p.m.
Pink: HRG