HomeMy WebLinkAboutSump Pump Inspection~ 4F PRIp~'
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Name: L.l /~/ S S ~;~~C-'~1r~~- Q Date~"'~~" ~/ Time,~'`~`~~a.mJp.m.
,~''n~ ~ ~ ~~,~~ First Inspfe ~'on ~""Second ~
Address:b~Ui~ o'~~p~~~ Own: ~'' Rent: .- Age of Home:~~
,~/~~f Residential: ~ ~
Prior Lake, MN 55 ~~~ Phone: 7"~ ~~`-~~°~ Non-Residential: ~
A. BASEMENT ~ s ~ No~~ 5UMP BAS T~,~~ 1 ~ 2 ~ 3 O
WATER IN BASKET ~ Yes [9"No SUMP P L9 0 O 1 ~ 2~~ _~/~ ~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ 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 ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain L~ Other
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Prior to Inspection: 'r`
When was system installed, or most recently modified? (Date) and w ~
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement O Prev' s system failed ~
B. ROOF LEADERS: Yes ~ N DI5CHARGE: Q Near L4'Away
C. YARD DRAINS Q Yes WINDOW WELL5 I~Yes Q No
BEAVER 5YSTEM ~ Yes o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer ~ Srpring O Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~.Back ~ Side
NOTES:
SUMP PUMP SYSTEM: L7 ASS ~ FAIL You have 30 days to bring your system into comp[iance with curre
regulations. When you are ready jor reinspection, call 6511644-1469 for an ~ntment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to be d so e clear w er di rges to the storm sewer system.
Inspector: Date: _ ~~ -
Resident: , ~ ~ ~ : ),~.,,, 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