HomeMy WebLinkAboutSump Pump Inspection~{~ ~F PRI p~'
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Name: ~ Date:~ Time• a.m./p.m.
~/~!~y~y ~,.~~ ~ C~~ ~~- First Inspec~n ~ Second ~ ~
Address."7 / 1 ~ ~ t~ Own: ~'' Rent: ~ Age of Home:
~ , ~~~/ J~~ Residential: ~
Prior Lake, MN 55 ~~ Phone• Non-Residential: ~
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A. BASEMENT [~Y4'es ~,,P~o SUMP BASKET ~ 0,~•~d~I ~ 2 ~ 3 ~
WATER IN BASKET f~'"~es ~ No SiJMP P~~ ~0 ~ 1 ~ 2~ ~~~ /3 O
WATER IN BASEMENT (flow over floor) ~ Yes QL~Qo CISTERN ~ Yes CYl~'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 ~,,,..~ Q Outside
at Inspection: 17 Floor drain Q Other
Prior to Inspection:
When w system installed, or most recently modified? (Date)
Home came with system ~ Res onse to inspection program
P
Q Water in basement ~~ Previous sy failed
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~ Other
and why
B. ROOF LEADERS• ~~11 ~/ L~ Yes No DISCHARGE: ~ Near ~ Away
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C. YARD DRAINS ~,' L) es ~ No WINDOW WELLS O Yes ~P~6"'~~
BEAVER SYSTE~ n~ j,~ ~~ Yes ~ No
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D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer ~ Spring ~ Winter
(check a11 that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ B,~- ~ Side
NOTES:
SUMP PUMP SYSTEM: E'1' PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651/644-1469 for an appot nt.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~#''No
Where is this location?
This area will need to be ed~e clear~v ater~harges to the storm sewer system.
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~ Inspector: • %G ~ Date: "`~~ - ~..~ ' y' y I
Resident: , ,4,~( ~'.,~,.~ 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: Gity , Pink: HRG