HomeMy WebLinkAboutSump Pump Inspection~
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Name: ~i~ ~
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~,~,~J ~
~G;/~~~~ ~ Date~ ~~ ~9 Time~~a~a.m./p.m.
~/ ~1 / ,~ First In~sp,e ~on EI~ Second ~
Address : 'y,~" 7 ~~~'L ~~~ ~ ~7r ~~ Own: ~' Rent: ~ Age of Home:
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,~/,/ ,/ Residential: ~
Prior Lake, MN 55 ~~~ Phone:7'~` y~~~"7" Non-Residential: ~
A. BASEMENT t~f'es ~ No ~ 5UMP BASKET E'I 0/'d 1 7 2 ~ 3 ~
WATER IN BASKET ~ Yes o SiTMP P~ 1~' t~~0 ~ 1 ~ 2 ~ j 3' ~
WATER IN BASEMENT (flow over floor) ~ Yes f~No CISTERN ~ Yes L' 1 I To
(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 sew~r-- Q Outside
at Inspection: ~ Floor drain O Other
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Prior to Inspection:
When was system installed, or most recently modi~ed? (Date) and why
17 Home came with system ~ Response to inspection program ~ Other
Q Water in basement ~ Pre ' us system failed
ROOF LEADERS: L~' Yes ~ No DISCHARGE: ~ Near wa
B. Y
C. YARD DRAINS ~ Yes L9~~~ WINDOW WELLS ~ Yes ~'No
BEAVER SYSTEM ~ Yes C~'No
D.
NOTES:
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer D~Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? Q Front ~ Back ~ Side
SUMP PUMP SYSTEM: P~PASS ~ FAIL You have 30 days to bring your system into comp[iance with current
regulations. When you are ready for reinspection, ca[[ 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L9~1vo
Where is this location?
This area will need to b ed e clear w~xer djs~eharges to the storm sewer system.
I Inspector: l~°G - Date: ~-/~ = Y7 I
Resident: ,~ ~ Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not impl_y the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG