HomeMy WebLinkAboutSump Pump Inspection.n
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City of Prior Lake
~~ Sump Pump and I/I Reduction
Inspection Form ,~~~,-~,-
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Name: (~l/~~~~C ~.(/~ ~G~ ~.C~i4~.t Date:~"~" ~~ Tirne:~.~a.m./p.m.
/ ,.~ First Inspe,~tion ~cond L7
Address: ~~O~IQ ~~~~~ ~/ ~~~ ~ Own: LL9~ Rent: Age of Home: ~J9 ~
,~/./ , Residential: ~ ~
Prior Lake, MN 55~~~ Phone:"~''`~`~i~~9~ Non-Residential: ~
A. BASEMENT I~es ~ No~~ ~ SUMP BASKET ~~~ 1 O 2 ~ 3 ~
WATER IN BASKET ~ Yes a.P~o * SiJMP -P ~J 0~ 1 ~ 2 ~ 3
~ J
WATER IN BASEMENT (flow over floor) ~ Yes L~NO CISTERN O Yes
(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: I~ Floor drain ~ Other
~
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: Q''Yes ~ No DISCHARGE: ~ Near ~Away
G YARD DRAINS r~E~~G~L~" Yes WINDOW WELLS es ~ No
BEAVER SYSTEM ~ Yes o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? d Fall ~ Summer ~ Sprin~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back Q Side
-•-•-•---•-•-•-•---•-•-•---._.-•-•--- - ---•-•-•-•-----•---•-•-•-•-•-•-•-----•-•--------~--•-----•-•-•---•-•-•-----•---•-----•-•-
NOTES:
SUMP PUMP SYSTEM `. [D~'PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca11651/644-1469 for an ap ' ent.
Is there another place where clear water enters the sanitary sewer system? Q Yes L~#''.~
Where is this location?
This area will need to be~ced~,s~ the clear~nat~r~'ischarges to the storm sewer system.
Inspector:
Resident:
~ . .r ~
Date:
Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not implv the structure meets all City Codes.
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White: Homeowner Yellow: City Pink: I~RG