HomeMy WebLinkAboutSump Pump Inspection,h
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name: ~:~i~.~~- j cUc.ir~i(/ Date:t.,~'"~~ ~/ Time~.m./p.m.
/~ ~
/ ~/ ~ First In-sp~e ' n ~"'" Second ~ ,~/
Address: ~~~" Q~~~~~J ~~ v~ Own: ~ Rent: ~ Age of Home' Y/
r~ ,~fry Residential: ~ ~
Prior Lake, MN 55 ~/~ Phone. 7/~~'~~Non-Residential: ~
A. BA3EMENT ~s ~ No ~/ SiJMP BASKET A~~'~6~ ~1 Q 2 ~ 3 ~
WATER IN BASKET ~ Yes f9'l~o . SiJMP P~ L9''0 Q 1 ~ 2~ ~ ~3
WATER IN BASEMENT (flow over floor) ~ Yes ~~~Qo CI5TERN ~ Yes 19~do
(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 I~ Outside
at Inspection: Q Floor drain ~ Other '~
Prior to Inspection: ---
When was system installed, or most recently modified? (Date) and why
Q Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previo system failed
B. ROOF LEADERS: es ~ o DISCHARGE: ~ Near ~
, ~j ~ ~~
C. YARD DRAINS ~ r~(~ es d~ N~o WINDOW WELi.S es a No
BEAVER SY5TEM ~ 4~~1~ Yes Q•'1Vo
Q~ U~
D. PROPERTIES V~I~~UMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Sprin~ !a Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front C'a Back ~ Side
NOTES: ~---•-•-•--- -•-------•-•---•-•-•-•-•-•-•-•-•-r •-•-•---•-•-----•-•---•-•-----•-•---•-•-•-----•-•---•-•-•-•-•-•---•-•-
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for rein.spection, call 651 /644-! 469 for an ap ' ent.
Is there another place where clear water enters the sanitary sewer system? Q Yes o
Where is this location?
This area will need to xe the clear w r' ges to the storm sewer system.
Inspecto • ~~~ Date: ,~ - ,,$~- ~
Res' en : D~te: S' - ~ -
Disclaime . ' visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner
Yellow: City
Pink: HRG