HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name: ~~D~~S~~ ~'~'~ Date: / ~~~/ Time: ~/ ~~.m./p.m.
/~~~ ~ ~~~~ ~ ~~,,~~ First Inspection ~cond ~ ~ ~
Address: ,/ ~ Own: ~'` Rent: ~ Age of Home: ~
~~ ~,~ ~ Residential: ~
Prior Lake, MN 55 ~~Z- Phone. Non-Residential: ~
A. BASEMENT es C] No ~ 5UMP BASKE t~"Q/~ 1 IJ 2 O 3 ~
WATER IN BASKET ~ Yes o SUMP P ~0 ~ 1 ~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes o 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 ____a Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection: ~'"""
When was system installed, ar most recently modified? (Date) and why
~ Home came with system
~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program ~ Other
~ Previo ystem failed
el~L~o DISCHARGE: ~ Near ~Away
~ Yes C~~k'N/o ~ WINDOW WELLS 9~'f~es Q No
~ Yes m.~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run7 ~ Fall O Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? ~
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: IDiPASS ~ 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 app ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C~'~No
Where is this location?
This area will need to be ed s clear wat dis~rges to the storm sewer systerr~:
Inspector: - ~~~ °--~'' Date: '~-/-- /D - 7' %
Resident: ~T, , ~rs Date: / U
Disclaimer: ~`his~visual inspection is done with due diligence to find obvious clear water cross-connections I
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG