HomeMy WebLinkAboutSump Pump Inspection~ aF PR,~p
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form ~~~-~
Name: ~t~~~~~~~~~~ iL/(~,~'/'y~~ Date~%~'~~Time:~~~~a.m./p.m.
,~/~/ iO~ p~~Q~ ~,~. First In~sp_e,,c ~' n~-~econd ~
Address: " ~`~ ~ ~~ Own: L~ Rent: ~ Age of Home:~
,/~/ Residential: ~ ~
Prior Lake, MN 55 ~~~ Phone: 7'`~` ~~~',9 Non-Residential: ~
A. BASEMENT ~ Q No / 5UMP BASKET ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes lD~2Qo SiJMP~]~U~~ 0 CI 1~ 2~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN Q 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 Q Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other '''
Prior to Inspection: _,.,...
When was system installed, or most recently modified? (Date) and why
~ Home came with system la Response to inspection program ~ Other ~"'~`
~ Water in basement ~ Previo system failed
B. ROOF LEADERS: ~ o DISCHARGE: ~ Near ~L~vv
C. YARD DRAINS ~ Yes N~ WINDOW WELLS ~No
BEAVER SYSTEM D Yes I~' Y' N o
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Sprin O Winter
(check all that apply) How often does pump run?
Wthere does purnp discharge to outside? ~ Front ~ Back ~ Side
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NOTES:
SUMP PUMP SYSTEM: l~'~ASS Q FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[l 651/644-1469 for an appo' era.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be ed~e clear ~ter~arges to the storm sewer system.
Inspector:
Resident:
Date: ~G '.
Date: ~Z
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