HomeMy WebLinkAboutSump Pump Inspection_ r ~(~ ~F PR,~~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~,~,~J~
1~~?~.//,~~ Date~"'~~~G~~ Time/a~~.m./p.m.
Name :1,~ ~~~'~'~= ~~
,~//~ ?~„ First Insp tion L~]'" Second Q ~y
Address: - 7~9~ (_. d~~~ ~ ~~ ~~ ~~ Own: ~Rent: ~. Age of Home: ~ /
~y ,/ ~/ Residential: ~ ~
Prior I,ake, MN 55~/~ Phon~7~ 7~~'~/~ Non-Residential: I~
r v ... ` - ~.- '.~ `~.~..
A. BASEMENT es ~ No~ SUMP BASKET ~ ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o SUMP _P~ 0 O 1 ~ 2_ ~~ ~
WATER IN BASEMENT (flow over floor) ~ Yes CI]~Qo / CISTERN ~ Yes L9'No
(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
at Inspection:
~ Laundry tub ~ Sanitary sewer ~O Outside
Q Floor drain ~ Other
Prior to Inspection: "'~
When as system installed, or most recently modified? (Date) and why
ome came with system ~ Response to inspection program ~ Other
Water in basement Q Pre 'ous system failed
B. ROOF LEADERS: t9' Yes ~ No DISCHARGE: I~~1Vear ~ Away
C. YARD DRAINS ~ Yes L~~~~ WINDOW WELLS Q Yes L'4'N~o'
BEAVER SYSTEM ~ Yes Q No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall Q Summer ~ Sprin~- ~ Winter
(check all that apply) How often does pump run? _ __
V~here does pump discharge to outside? ~ Front ~ Back 0 Side
NOTES:
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SUMP PUMP SYSTEM: 'L'~'"PASS Q FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[[ 651 /644-1469 for an ap ' ra.
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 ix~~he cl~ w~ discharges to the storm sewer system.
, _ -- _
Inspector:
Resident:
Date: ~.,5 - ~ ~ "
Date: ~ - // - ~
Disclaimer: This visl~l inspection is done with due diligence to find obvious clear water cross-connections
and does not implv the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG