HomeMy WebLinkAboutSump Pump Inspection1b 4F PR,lp
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City of Prior Lake
Sump Pump and I/I Reduction
ion Form
Name: ~~ f~~' / ~ ~'~, ( ;~ 1. ~~-~ ~~ 1 ~ z ~ ~ r -~'~.
Address: : r ~ ~~ l~ o a ~ ~ ,.~ ~
Prior Lake, MN 55~~ Phone: ~~~ ~~
Date: ~-~ ~~ -~~ Time: G ~° a.m./p.m.
First Inspection ~Second ~
Own: O" Rent: ~ Age of Home: ~1/~~
Residential: C~-'" ~ ~~, ~,.~ ~f ' ~~ ~
Non-Residential: D N~ .~ ~d,~~ ~~ f~
w~ € ~ ~v~r- ~~
A. BASEMENT ~es ~ No SUMP BASKET ~ 0 13 1 O 2 ~ 3 ~
WATER IN BASKET C~'~es Q No SUMP PUMP I~'"0 ~ 1 ~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) a Yes I~hio CISTERN Q Yes A~#ci
(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 C7 Laundry tub t] Sanitary sewer a Outside
at Inspection: O Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
O Home came with system D Response to inspection program a Other
~ Water in basement C] Previous system failed
B. ROOF LEADERS: ~ Yes L~'fi`o DISCHARGE: ~ Near t] Away
C. YARD DRAINS l7 Yes 13'1Go WINDOW WELLS ~ Yes 13'~
BEAVER SYSTEM ~ Yes ~'1Qo
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? ~1 Fall ~ Summer O Spring ~ Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? D Front Q Back O Side
NOTES: ~+n~~ ~r ~---f-r~ v. s -( ~ w ~ ~ ; ~~ -•-•-•---•-•-•-•-•-•-•---._.---•-•-•-----•-•---•-•-----•-•---•-
SUMP PUMP SYSTEM: C~'PASS O FAIL Xou have 30 days to bring your system into comp[iance with current
regulations. When you are ready for reinspection, caU 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~ No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
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f Inspect r~.~ V~ L~ Date: ~- 2 t(- `~ `/ I
~ Resident: ~.~., ,~, ~ ~ c~ Date: G~~~-(- 9 g
Disclaitner: 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