HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Name: ,~t.1~~~~-~ ~~ J~-~,C, ~'~N Dat~~~c-°~' /~~ Time~d ~~.m./p.m.
~g, ~ ~~ First I~ns_pfe ~' ~n L~Y'" Second 17
Address:,~ % ~ ~ ~~'~~ ~~~ ~ Own: ~3"" Rent: ~ Age of Home: ~
~ ~/ Residential: t~`r
Prior Lake, MN 55~ ~~ Phone'~j~°Y~ ~~ ~ Non-Residential: ~
~, ~.w~ ic. ~
A. BASEMENT * I~ No~ SUMP BASKET ~ 1 d 2 ~ 3 ~
WATER IN BASKET Q Yes o SiTMP PU~ 0~ 1 ~ 2 ~~C]
WATER IN BASEMENT (flow over floor) O Yes L'~'l~io CISTERN ~ Yes I~a~l~fo
(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 O Laundry tub ~ Sanitary sewer l7 Outside
at Inspection: ~ Floor drain ~ Other ~''"
Prior to Inspection: .~-
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program Q Other
~ Water in basement Q Prev' s system failed
B. ROOF LEADERS: L~~No , DISCHARGE: ~ Near way
C. YARD DRAINS ~ Yes ~.~~~~" WINDOW WELLS O Yes I~'No
BEAVER SYSTEM D Yes @" NO
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer O Spring ~ Winter
(check all that apply) How often does pump run? ''"~
V~here does pump discharge to outside? ~ Front ~$ack ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ASS ~ 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? ~ Yes ~~'i~1'o
Where is this location?
This area will need to ix o the clear ter~iischarges to the storm sewer system.
Inspector:,~~~_~
Date: Z - Z 3- ~ ~' ~
Date: Z • z 3 -
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