HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
ection Form
Name:/ ` ~~ ~ /~~ ~LG ~.t,/~C
Address: '7`~~~ ~~~C~ ~7~ /U~ ~
Prior,Lake, MN 55 ~ /~ Phone~~ /iG~o
~~~'~ ~'
Date:~~"~~ Time;~~.;>a.m./p.m.
First Ins~p~e ' n(~' Second C]
Own: L9'" Rent: Age of Home:~
Residential; ~ J
Non-Residenrial: ~
ivv~.uc: ~ ~
A. BASEMENT es ~ No SIJMP BASKET 0 1 ~ 3 ~
WATER IN BASKET ~ Yes o SUMP P O 1 ~ 2.~~''C~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN (~ Yes ~~fo
(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 O Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: a Floor drain ~ Other ''~'
Prior to Ins ction: ~
When system installed, or most recently modified? (Date) and why
Home came with system ~ Response o inspection program ~ Other
~ Water in basement ~ Prev' s system failed
B. ROOF LEADERS: es ~ No DISCHARGE: ~ Near ~way
C. YARD DRAINS D Yes f~~N ~ WINDOW WELLS ~ Yes o
BEAVER 5YSTEM O Yes [~''No
D. PROPERTIES WITH SUMP PUMP5
When does pump run? ~ Fall C7 5ummer ~ Sprin~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back O Side
NOTES:
SUMP PUMP SY$TEM: ~,/~ASS ~ FAIL You have 30 days to bring yaur system into compliance with current
regulations. When you are ready jor reinspection, cal[ 651 /644-1469 for an ap ' ra.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be f d so~ clear wa~er c}isy'~larges to the storm sewer system.
Inspector:
Resident:
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.
Date:
- Date:
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White: Homeowner
Sump Pump and I!I Reduction
Yellow: City
Pink: HRG