HomeMy WebLinkAboutSump Pump Inspection~ aF PRIp
~ ~ a ~~ ~
~~ ~ ~
~ ~
,p
City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: ,~~~~ /1 C/~ ~i~ri~4~.E~E~ Date•r~~~~Time~L~~~=6?~a!m./p.m.
,//~ ~~ First Inspectio Second L7
Address:~~~'~` (,.~ ~~,Dl~ ~D/~ ~ Own: ent: ta Age of Home: '~~
~ ~/,(y / ,.~,/ Residential: L7
Prior Lake, MN 55 ~/v~ Phone:7'~'~~' /'lv~~C.~ Non-Residential: ~
A. BA5EMENT ~ Yes ~Go~ /''~ SiJMP BASKET ~_~,,~~ 2 ~ 3 ~
WATER IN BASKET 17 Yes t~'No SUMP P A''0 Q 1 Q 2 ~Q ~3,,,1~'
WATER IN BASEMENT (flow over floor) ~ Yes o CI5TERN ~ Yes ~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 ~ Outside
at Inspection: ~ Floor drain ~ Other ~'"~
..~
Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
Q Water in basement Q Previous system f iled
B. ROOF LEADERS: ~ Yes o DISCHARGE: ~ Near l7 Away
C. YARD DRAINS a Yes L~_~_~Ny~ WINDOW WELLS ~ Yes ~
BEAVER SYSTEM ~ Yes L~'No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall ~ Swnmer Cl S~,~j,~g ~ Winter
(check all that apply) How often does pump run? "
Wthere does pump discharge to outside? ~ Front Ca Ba~Ic O Side
NOTES:
SUMP PUMP SYSTEM: LZV~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regularions. When you are ready for reinspection, call 651 /644-1469 for an appointr
Is there another place where clear water enters the sanitary sewer system? Q Yes o
Where is this location?
This area will need to b~so the clea~~ischarges to the storm sewer system.
( Inspector: L~~"~l ///.~'"cc~`'`~- -`~'~ `.`..,~.~ --- Date: L 'LS -Y7' I
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 Pink: HRG