HomeMy WebLinkAboutSump Pump Inspection4~ PRIp
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Name: rq~ ~ 1 S C. ~~/S ~/.t/.~
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Address: /~.~~Z ~ ~'~ u °~ ~ Q~ ~ ~/~
Prior Lake, MN 55 '3!~~ Phone~'~'i~0-g~-Zz
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A. BASEMENT es a No~ SUMP BASKET ~ 0 O 2 ~ 3 ~
WATER IN BASKET ~ Yes o SUMP~ PUM~ ~ 1 ~ 2~ ~~ Q
WATER IN BASEMENT (flow over floor) ~ Yes Q I~ o CISTERN ~ Yes L~ l- 1 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.)
Discharge Point ~ ~ Laundry tub L? Sanitary seweL,~ ~ Outside
at Inspection: O Floor drain ~ Other
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Prior to Inspection:
When s system installed, or most recently modified? (Date) and why
Home came with system '~ Response to inspection program I'~ Other
Q Water in basement ~ Prev' s system failed
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B. ROOF LEADERS: ~(j,~~~ Yes ~ No DISCHARGE: ~ Near Away ~
~ ~ ~ /~
C. YARD DRAINS ~ Yes ~L~ WINDOW WELLS ~ Yes L~1Vo
BEAVER SYSTEM ~ Yes ~'No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer O Spring ~ Winter
(check all that apply) How often does pump run? "~
V~here does pump discharge to outside? I~ Front ~ Back Q Side
NOTES; ,
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SUMP PUMP SYSTEM: ASS ~ FAIL Ynu have 30 days to bring your system into compliance with current
regulations. When you are ready Jor reinspection, ca[[ 6511644-1469 for an appot ent.
Is there another lace where clear water enters the sanitary sewer system? ~ Yes miNo
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Where is this location?
This area will need to e xe the clear w er ischarges to the storm sewer system.
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Inspector: Date: ~
Resident: , l ~ -. , _S • Date: _ _ '(, _ -`
Disclaimers 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.
City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Date: ,~-C -~~ Time:/~~-~a.m./p.m.
First InLsp~ec 'on t9' Second ~
Own: L~' Rent: ~ Age of Home: ~~
Residential: ~ •
Non-Residential: ~
White: Homeowner
Yellow: City
Pink: HRG