HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
~~'~""
~ ~' ~ >
Name: ~ G~~~iCO/`7 f..r ~~. ~~ Date~ ~~~~ Time: /~~~a.m./p.m.
~L/ ,/ ,.~First Insp~e n e'" Second ~
Address: 'Y ~'7' ~~~/9~~ y 7~ /f`~~ Own: A'' Rent: Age of Home:
h ,// Residential: ~
Prior Lake, MN 55 ~?~~/ Phone:7`7~~'~i~'`~,9 Non-Residential: ~
A. BASEMENT ~`i'es ~ No ~~/ SiJMP BASKET ~ 1 O 2 L7 3~
WATER IN BASKET ~1 Yes Q'No SiJMP P~~~ 0~ 1 ~ 2~ Q~~
WATER IN BASEMENT (flow over floor) C~ Yes ~ N o CISTERN Q Yes ~- I Q 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.)
C. YARD DRAINS ~ Yes ~~ WINDOW WELLS ~ Yes C~'No
BEAVER SYSTEM ~ Yes f9''No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall Q Summer ~ Spring a Winter
(check all that apply) How often does pump run? "^
V~here does pump discharge to outside? ~ Front I~ -$ack Q Side
NOTES:
B. ROOF LEADERS: Q~I'es ~ N DI5CHARGE: I~ Near LtYAway
Discharge Point ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other `~
Prior to Inspection: ""
When s system installed, or most recently modified? (Date) and why
L7 Home came with s stem D Res onse to ins ection rogram ~ Other
Y P P P
~ Water in basement ~ Prev' us system failed
SUMP PUMP SYSTEM: ~"~ASS O FAIL You have 30 days to bring your system into compliance with cwrent
regulations. When you are ready for reinspection, call 6$1J644-1469 for an intment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes E#'"No
Where is this location?
This area will need to be f d s~ clear wa~ dis~ges to the storm sewer system.
Inspectar:
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: ~ ' y '
Date: -~~`
1
White: Homeowner
Yellow: City
Pink: HRG