HomeMy WebLinkAboutSump Pump Inspectionrt I~ ~F PRJp~'
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
Name:~~~~~ , W~
Address: 'y~~ ~ C.. Q.GO.e~~"I [~4 ~~~.G~
Prior Lake, MN 55 ~~ Phone:'~`~5'` ~~~~~
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Date: .~ %~~"~ Time:~ .m./p.m.
First Insp~e ' n L~ Second O ~
Own: ~ Rent: Age of Home:~
Residential: ~
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Non-Residential: ~
A. BASEMENT f~'Yes ~ No SUMP BASKE 1~ 2 ~ 3 ~.
WATER IN BA5KET ~ Yes o SiJMP P 0~ 1 Q 2 ~~' ~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN 17 Yes ~~l~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
at Inspection: O Floor drain
Prior to Inspection:
When was system insta.lled, or most recently modified? (Date).
and why ~
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement Q Prev' system failed
B. ROOF LEADERS: ~No DISCHARGE: O Near wa
Y
C. YARD DRAINS a Yes WINDOW WELLS ~ Yes(~'No
BEAVER SYSTEM ~ Yes o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back Q Side
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NOTES:
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SUMP PUMP SYSTEM: ~YASS ~ FAIL You have 30 days to bring your system into compliance with rent
regulations. When you are ready for rein.spection, caU 654/644-1469 for pointment.
Is there another place where clear water enters the sanitary sewer system? I~ Yes No
Where is this location?
This area will need to b ed e clea~at~scharges to the storm sewer system.
Inspector: ~
Resident: ~t /.
Date: .G -.G.S -
Date: ~ ~ -
Disclaimer: This visual inspec~ion is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
Ca Sanitary sewer ~ ~ Outside
O Other
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White: Homeowner Yellow: City Pink: HRG