HomeMy WebLinkAboutSump Pump Inspection~/, 4F PRIo
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City of Prior Lake
Sump Pump and I/I Reduction
ction Form
Name: ~~~,~~~, ~i~/~9~c.1
Address: ~,~0~ (~ o~ D,~%~,00 ~j' ,5,~
Prior Lake, MN 55 ~~~ Phone7~~ ~~
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Dat~'~~-~~ Time~'~~~ a.m./p.m.
First Inspection 19~ S nd ~ O S.
Own: ~ Rent: Age of Home ~~-(
Residential: `-~
Non-Residential: ~
A. BA5EMENT f~'Y'es ~ No SiJMP BASKET PI,sY'~ 1~ 2 ~ 3 O
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WATER IN BASKET ~ Yes o 5UMP Pi~P I~o ~ 1 a 2~ ~
WATER IN BASEMENT (flow over floor) ~ Yes [~'No CI 5TERN ~ Yes 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 ~ Laundry tub Q Sanitary sewer ~ Outside
at Inspection: Q Floor drain ~ Other ""'"
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Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system
~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program ~ Other
~ Previous system failed
~ Yes @' No DISCHARGE: ~ Near ~ Away
~ Yes ~~~' WINDOW WELLS ~ Yes ~No
~ Yes L~' No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
~ Spring ~ Winter
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V~here does pump discharge to outside? ~ Front Q Back ~ Side
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NOTES:
SUMP PUMP 5YSTEM: ASS ~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready for reinspection, cal[ 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~No
Where is this location?
This area will need to b xeyi~ the cle~w~te,r discharges to the storm sewer system.
Inspector:
Resident:
Date: .,.3-/ ~
Date: ~
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