HomeMy WebLinkAboutSump Pump Inspection Program~F PRIp~
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
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Name: /~ ~ ~A~ ~-, Date: ~ ~TimeY~'~~mJp.m.
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`~~~~ ~~~,~ ~~~~~~ First Inspe on ~7'' econd L~
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Address:,/ Own: ~ Rent: ~ Age of Home:~
Residential: ~''~~
Prior Lake, MN 55 ~~Z P ne:~`~~' ~~'~~' Non-Residential: ~
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A. BASEMENT es ~ o SiJMP BASKET Q 0 ~~ 2 O 3 ~
WATER IN BASKET es ~ No SUMP P~~ ~ 0 @` 1~ 2~ ~~ ~3.--~.~
WA1'ER IN BASEMENT (flow over floor) ~ Yes ~YNo CISTERN ~ Yes C~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 ~ Sanitary sewer utside
at Inspection: a Floor drain ~ ~ther
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~~~ and why
O Home came with system esponse to inspection program ~ Other
~ Water in basement ~ Pre ' us system failed
B. ROOF LEADERS: Yes ~ No DISCHARGE: ~ Near ay
C. YARD DRAINS ~ Yes L°I~~ ~,N,~ WINDOW WELLS ~ Yes CJ No
BEAVER SYSTEM ~ Yes £1'"No
D. PROPERTIES WITH SUMP PUMPS ~/'~
When does pump run? ~ Fall Q' Summer S~prin~ ~/~ inter C
(check all that apply) How often does pump run? /`" ~"~- K- ~4 /~ C~E~ 7
V~here does pump discharge to outside? ~ Front ack ~ Side
NOTES:
SUMP PUMP SYSTEM: ASS L7 FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes L~'No
Where is this location?
This area will need to fix o the cle -tiva~erJdischarges to the storm sewer system.
1 Inspector:/~- ' ~~`'``%/- ` Date: "7' '~` 7 7 I
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Resident: _ ; ~~ ~ ~ ; . ,~~ _;,,~..~.~_ 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 PinF: HRG