HomeMy WebLinkAboutSump Pump Inspection~ .~ ;' ~'~ ~C.~ n` f
City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name:~~'~~h;'~(,~~-~'i2~ ~-~jp~~~ ~Date: .,;30 -~ Time~a.m p.m.
First I s ection Second ~
Address ~~~~~ ~/!/j~ ~~ ~d/= ~~' Own: j~ Rent: Age of Home:
Residential ~
Prior Lake, MN 55 Phone: Non-Residential: ~
A. BA5EMENT ~ Yes l~`ATo SUMP BASKET ,~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes 17 No 5UMP PiJMP ~0 ~ 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) I~ Yes ~ No CI RN ~ Yes ~ No
(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
at Inspection:
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
C. YARD DRAINS ~ Yes No WINDOW WELLS 17 Yes O No
BEAVER SYSTEM ~ Yes No
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer Q Spring Q Winter
(check all that apply) How often does pump run?
V~here does pymp discharge to outside? l~ Front Q Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS ~ FAIL You have 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, cal[ 651 /644-1469 for an appointment.
Is there anocher place where clear water enters the sanitary sewer system? ~ Yes ~ No
Where is this location?
This area ' nee to b~ed so the clear w r'scharges to the storm sewer system.
.
Resident:
Date: ~ : ~'~ "'
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.
~ Laundry tub ~ Sanitary sewer l7 Outside
Q Floor drain ~ Other
V
White: Homeowner Yellow: City Pink: HRG