HomeMy WebLinkAboutSump Pump Inspection~ S{P N~f~ .:
City of Prior Lake
Sump Pump and IiI Reduction
ection Form
s
, ~ ~ ~ ~„ ~ ,i
Name : f ~ ' ~ ~ ~ '/" ~ ~
Address: l~~ ;,~ `7 7~~ 1„< <I y~ r~:~ i~ i ~ i. dV ~~
Prior Lake, MN 55 ; I~ Phone: ~' ~l '~- ~i 3 ~? 7
Date: ~/ .~ ~- y r Time: ) I~'~ a.m./p.m.
First Inspection t~ Second ~
Own: ~' Rent: ~ Age of Home: ~~
Residential: L3'
Non-Residential: Q
~~.~~; ~ ~,~ fi
A. BASEMENT t~'es ~ No SUMP BASKET ~~ 1 ~ 2 ~ 3 a
WATER IN BA5KET ~ Yes ~ No SUMP PiJMP ~0 ~ 1 ~ 2 Q 3 Q
WATER IN BA5EMENT (flow over floor) O Yes C-~'No CISTERN ~ Yes C~'°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
at Inspection:
~ Laundry tub f7 Sanitary sewer f7 Outside
~ Floor drain ~ Other
Prior to Inspection:
When was system i~stalled, or most recently modified? (Date)
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement O Previous system failed
and why
B. ROOF LEADERS: C~"Yes O No DI5CHARGE: ~' Near C] Away
C. YARD DRAINS ~ Yes C+3" No WINDOW WELLS {7 Yes C3~'~o
BEAVER 5Y5TEM ~ Yes l~' No
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer O Spring ~ Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES: ~rA1V.• lV~ ~~M \..h~/~• t "~qT •~Olf ua~^~ S/Dt~Nd. •A+^~• t~~'Ai~~,d •~• ~s..1/ ~6 9~l- •41- •/~r~r_'_'_'_
_ . ~ . ~ i ... ~ .
SUMP PUMP SYSTEM: ~ASS t] FAIL You have 30 days to bring your system into comp[iance with current
regu[ations. When you are ready for reinspection, ca11651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes [3'No
Where is this location?
This area will need to be fixed so tihe clear water discharges to the storm sewer system.
Inspector: ` t,~ Date: `/- .~ y- 94
Resident: ~( ~(~~,~ Date: ~/- ,1 y - yQ
Disclaimer: This visual inspection~lis done with due diligence to fiind obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG