HomeMy WebLinkAboutSump Pump Inspection~ ~ ~1~~
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City of Prior Lake
Sump Pump and I/I Reduction
ction Form
Name : ~v ~1~`~ /•~GG ~ /~~ ~,/ LC ,t~,
Address: ~~1 ~ ~ ~~ ~ v ~ ~~ ~'" ~
Prior Lake, MN 55 ~~,~i Phone:Y''~~ ~~ 7~
'~~J ~
Date: ~" ~ ~~ Time:/~~G?a.mJp.m.
First Insp ion ~ond ~ ~
Own: Rent: Age of Home: ~
Residential: ~ ~
Non-Residential: Q
A. BASEMENT ~es C] No~ SiJMP BASKET ~ a 1 ~ 2 ~ 3 17
WATER IN BASKET ~ Yes o SIJMP~~ 0~ 1 ~ 2~ ~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes 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 ~ Sanitary sewe~, ~ Outside
~ Floor drain O Other
c
....-
Prior to Inspection: s
When was system installed, or most recently modified? (Date) and why
O Home came with system Q Response to inspection program ~ Other
~ Water in basement t] Pre ' s system failed
B. ROOF LEADERS: (~~, A~~'Yes D No DISCHARGE: ~ Near @~way
PP ~~~
C. YARD DRAINS Q Yes L~~' N~o WINDOW WELLS es ~ No
BEAVER SYSTEM ~? Yes D''No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Q Summer ~ S~ring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front a Back ~ Side
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NOTES: -•-/~OGG~ / /"L , - ~U ,Z.~.E'Ai~J_ ~~ L:_
SUMP PUMP SYSTEM: L~ YASS ~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready for reinspection, ca[[ 651 /644-1469 jor an ntment.
Is there another lace where clear water enters the sanita sewer s stem? CI Yes L~~
P rY Y
Where is this location?
This area will need to be ed ~Ae clear w~er d,js~harges to the storm sewer system.
Inspector:
Resident:
Date: ,-~ - 9-
Date: ~~
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imuly the structure meets all City Codes.
S
White: Homeowner Yellow: City Pink: HRG