HomeMy WebLinkAboutSump Pump Inspection~ ~~ QF PRIp~~
~~ U ~
~
City of Prior Lake
Sump Pump and I/I Reduction
tion Form ,~~„~~~-
~
Name: ~ ~ ~./'°~~~ ~ Dates,..~ %~- 9~ Tim~Da.m./p.m.
, /O/'i~~7,,~~ ~, ` First In~sp~e 'on I~'Second L7
Address: ~~'~` ~-~ O ~~v Own: L9'' Rent: Age of Home:~~ 1
,/ r.,, Residential: ~ ~
Prior Lake, MN 55 ~~i~ Phone'~`~ ~~~~Non-Residential: ~
A. BASEMENT ~s~~ SUMP BAS ~ 0 1~ 2 ~ 3 Q
WATER IN BASKET es Q No SUMP P 0~ 1 ~ 2~0
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 L7 Laundry tub ~ Sanitary sewer.---~-~ ~ Outside
at Inspection: ~ Floor drain ~ ~ther __7~
Prior to Ins ction:
When system installed, or most recently modified? (Date) and why
Home came with system Q Response to inspection program ~ Otl~er
O Water in basement ~ Prev' s system failed
B. ROOF LEADERS: ~~~ Yes ~ No DISCHARGE: O Near Away
C. YARD DRAINS ~ Yes C~'N~~ WINDOW WELLS ~ Yes o
BEAVER SYSTEM I~ Yes ~~~1Vo
D. PROPERTIES WITH SUMP PiTMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? Q Front
NOTES:
D S~r' g ~ Winter
~ Back ~ Side
SUMP PUMP SYSTEM: I~ASS O FAIL You have 30 days to bring your system into comp[iance with current
regu[ations. When you are ready jor reinspection, cal! 651/644-1469 for an ap ' ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b f e~e clear ~r ~rges to the storm sewer system.
Inspector:
Resident:
Date: __ ~~~-~
Date•
Disclaimer: This 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 Xellow: City Pink: HRG