HomeMy WebLinkAboutSump Pump Inspection~~ 4~ PRIp~
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Ins~ection Form
Name: r ~~~~i~, ~~~~~
'~~'~
Date~~- !- ~ Tim~~ m. /p.m.
(~ ~,(~' First Insp tion ~ Second ~
Address~/~~ ~~~~~~ ~.D `~-' ~ Own: ~Re`n~t: Age of Home:
~>/ ~/ Residential: Q"
Prior Lake, MN 55 ~~,f~ Phone~7~/~~~,~~'' Non-Residential: Cl
A. BASEMENT ~'~Yes ~~1ia' 5IJMP BASKET ~ 0 1~ 2 ~ 3 ~
WATER IN BASKET CD~s ~ No SUMP~~~ Q 1 ~ 2 ~ 3
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ 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: O Floor drain ~ Other
Prior to Ins ction: ''~
When w system installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement l~ Previous system failed
B. ROOF LEADERS: Q Yes lDr1Qo DISCHARGE: ~ Near ~ Away
G YARD DRAINS ~ Yes L~~~_' ~N ~~ WINDOW WELLS ~ Yes ~~
BEAVER SYSTEM ~ Yes Q" No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? L~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? 17 Front
NOTES: ,,--
~ Spr~ ~ Winter
C] Back ~ Side
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into comp[iance with current
regutations. When you are ready for reinspection, call $51 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? L~ Yes 4~~~Qo ~
Where is this location?
This area will need to be f' sg,t~clear w~er ~jec~iarges to the storm sewer system.
I Inspector: /u,~``'' ''"" `,~-..''" Date: ..~ `7'- 7' 1 I
Resident: ,,. ,~ ,~ Date:
Disclauner: This vi~ual inspection is done with due diligence to find obvious clear water cross-connections
and does not impl_y the structure meets all City Codes.
City of Prior Lake
Sump Pump and I/I Reduction
White: Homeowner Yellow: City Pink: HRG