HomeMy WebLinkAboutSump Pump Inspection~ O v\PRt
n~, oF °~
4 ~
~~ `~~/ ~ ~
~J
City of Prior Lake
Sump Pump and I/I Reduction
ection Form
r >.~
~~~ ~
~
, p /
Name: ~~~ ~ /~~'(GC.,,,'~.~.~ Date~~~ ~/ Tim~i7o,~~~.m./p.m.
~~~~ ~~~~~ ~r ~/~,,. First Inspec,,~d'' n econd ~
Address: Own: ~ Rent: Age of Home:
~y~ Residential: ~
PriorALake, MN 55 ~/,~ Phone:'~~c'~~~,9' Non-Residential: ~
A. ~ BASEMENT 6Yges Q No ~ SiJMP BA5 O 0,/f~l ~ 2 ~ 3
WATER IN BASKET ~ Yes No SUMP P ~~ ~ 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 C] Laundry tub O Sanitary sewer/,.F~ Outside
at Inspection: Q Floor drain O Other
Prior to Ins ection: ,/~
When s system installed, or most recently modified? (Date) and why
Home came with system I~ Respons to inspection program D Other
~ Water in basement l7 pre ' s system failed
~ ~'~
B. ROOF LEADERS: /~ ,~) Yes ~ No DISCHARGE: I~ Near way
r~ ~ ~/
C. YARD DRAINS ~ Yes ~ WINDOW WELLS ~ Yes4~'No
BEAVER SY5TEM ~ Yes L~i~'No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? C7 Fall ~ Summer ~ Spring Q Winter
(check all that apply) How often does pump run? '`~~
V~here does pump discharge to outside? ~ Front Q Back ~ Side
NOTES:
~
SUMP PL1MP SYSTEM: CIYPASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca!! 651/644-1469 }'or an ouument.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~~No
Where is this location?
This area will need to be f d so lear wat~is~ges to the storm'sewer system.
Inspector: • /"~''~ Date:
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