HomeMy WebLinkAboutSump Pump Inspection~ aF PRZo
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Crty of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~,o,~~-
Name:~~~ ~ ~•~~ss.~ ~ S r Date:~%~~~~Time;/~~c~a.m./p.m.
,.- First Inspe ' J~'" Second Q
~ , ~~~
Address: '~,~~ ~~~~~~Q~ ~7~~ Own: I~' Rent: ~ Age of Home~<
~y 1~~/,~y esidential: ~
~ ~7`"~` / ;~.3~~'~Non-Residential: ~ ~
Prior Lake, MN 55 I~ Phone.
A. BASEMENT aYres ~ No~ SUMP BASKET 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o SUMP P 0~ 1 ~ 2 ~ 3~
WATER IN BASEMENT (flow over floor) a Yes o CISTERN Q Yes ~,pl~
(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 l~ Sanitary sewe= ~ Outside
a Floor drain 17 Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
~ Home came with system ~ Response to inspection program
~ Water in basement ~ Previou stem failed
B. ROOF LEADERS: es ~ No DISCHARGE:
v
and why
~ Other
~ Near y
C. YARD DRAINS ~ Yes /o WINDOW WELLS es ~ No
BEAVER SYSTEM ~ Yes ~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? Q Fall 17 Summer ~ Sprin~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Pront ~ Backr- ~ Side
NOTES: _ _
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance with curre
regu[atious. When you are ready for reinspection, ca11651 /644-1469 for an app ' 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 ed s~_ clear w_ d~ges to the storm sewer system.
i
Inspector: • -~ Date: ~ -.G~ ^
Resident: ..~ Lx..- 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