HomeMy WebLinkAboutSump Pump InspectionQ ~~ ~~ PRIp~,~
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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
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Name: ' .~i ~C~ G~// '~ Date: ~~Time~/~~.mJp.m.
/~y First In~sp~e on ~ Second ~
Address: ~tfi' /~~ ~~ ~~~ `S~ Own: L~` Re~nt: /~ Age of Home: 2 ~
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Prio~ Lake, MN 55 Phone ~~f ~y Non-Residential: ~
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A. ~ BASEMENT L~es ~ No ~ SUMP BA5KET ~~i~ 1 0 2 ~ 3 ~
WATER IN BASKET ~ Yes o 5UMP P~JMP I~'J'`0 ~ 1 ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes 1~ No CISTERN O Yes A-I~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: ~ Floor drain ~ Other ~
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Prior to Inspection: -
When was system installed, or most recently modified? (Date) and why
17 Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Prev' us system failed
B. ROOF LEADERS: es ~ No DISCHARGE: a
Near ID~Away
C. YARD DRAINS ~ Yes l9''N ~ WINDOW WELLS ~ Yes ~''1Go
BEAVER SYSTEM ~ Yes ~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Sp~ng ~ Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
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SUMP PUMP SYSTEM: ~ASS ^ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for rein.spection, call 651 /644-1469 for an ntment.
Is there another place where clear water enters the sanitary sewer system? O Yes o
Where is this location?
This area will need to b xe e clear wa d~:"_ 7_ges to the storm sewer syst m.
I Inspector:~.-~''"" ' `~c'`'""- _""""' Date: 'Y ` ~ - `~ ~' I
Resident: , , ~ ,~ ~~, _ i 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