HomeMy WebLinkAboutSump Pump Inspection~ ~ ~F PRIp
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C ity o f Prior Lake
S u m p P u m p a n d I/ I R e d u c t i o n
ction Form ,~~,~ ~~-
Name: ~~~ ~~ ~~ /`~' p~~''~ Date:~"~~ ~ Time/~~ a.m /p.m.
!/~y/~ ~r ~„ First Ins tion ~ Second Q
Address: `~ ~/~ (~~~~~/qO0 ~7~ b~~ Own: ~Rent: Age of Home:~~-
~y~/ ,/ Residential: ~ ~
Prior Lake, MN 55 ~/N Phone. .~1~ -~g,25~ Non-Residential: C~
. ~'7i.c,~. wea-T'~C',~.
A. BASEMENT ~'Yes Q No~~~~ SUMP BASKET 0~~'~ 1 O 2 ~ 3 ~
WATER IN BASKET ~ Yes L~'No SiTMP'P~ T 0 Q 1 ~ 2 Q ~3' ~
WATER IN BASEMENT (flow over floor) ~ Yes [~O CISTERN ~ 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 ~ Sanitary sewer ~ Outside
at Inspection: Q Floor drain Q Other ~
Prior to Inspection: """"~
When was system installed, or most recently modi~ed? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement 17 Previous syst failed
ROOF LEADERS: ~ Yes ~No DISCHARGE: ~ Near 17 Away
~ ~ / _ /
C. YARD DRAINS ~ Yes I~~~N/o WINDOW WELLS ~~es Q No
BEAVER SYSTEM a Yes ~'No
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? O Fall ~ Surnmer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? a Front
NOTES:
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~ Spring ~ Winter
Q_,,,,$ack ~ Side
5UMP PUMP SYSTEM: I~A5S C7 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 jor 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 be e~e cle~a~ischarges to the storm sewer system.
Inspector: :/a'`~" Date: -.~ /- yy I
Resident: Date: - -
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not im 1 the structure meets all Cit Codes.
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White: Homeowner Yellow: City Pink: HRG