HomeMy WebLinkAboutSump Pump Inspection~~
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Name
City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Date: ~'Vr ~~ Time:~~~~a.m./p.m.
/~/ '7'"~~ First Inspe~c ° ~C9'" 5econd ~
Address: ~t,,,7 r`/ b~~t~ '"` ~~ ~'~ Own: ~ R`ent~: Age of Home:_
L~f ~y Residential: L~
Prior ake, MN 55 ~ 7~ Phon~~~%~=~~ ~/~c~Non-Residential: ~
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A. BASEMENT I~L~~ SIJMP BASKET Q 0 1~ 2 O 3 ~
WATER IN BASKET es ~ No SUMP P ~~ ~ 1 ~ 2~ ~ ~3 CJ
WATER IN BASEMENT (flow over floor) ~ Yes C~~fo CISTERN ~ Yes ~-IQ"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: a Floor drain ~ Other
Prior to Ins ction: ~
When s system installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
l7 Water in basement
B. ROOF LEADERS: L"a Previo system failed
~No DISCHARGE: ~
Near
~K.lsCvay
C. YARD DRAINS ~ Yes C~
1V/o WINDOW WELLS Q Yes ~
BEAVER SYSTEM ~
~ Yes C~1Qo
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Sprir~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? a Front ~ Back ~ ~ Side
NOTES:
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SUMP PUMP SYSTEM: C~'~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready for reinspection, ca11651/644-1469 for an a ntment.
Is there another place where clear water enters the sanitary sewer system? Q Yes No
Where is this location?
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This area will need to b xed s clear wate,r~disc,J~rges to the storm sewer system. _
Inspector~,%~K1
Resident~ , ~_ _
Date: c.~ " J ~
Date: ~~
Disclauner: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not implv the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG