HomeMy WebLinkAboutSump Pump Inspection,~D
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U~ ~ City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name: ~~-~ ~i c~ c. ~, F p~, -~-~ ~`~L
Address: ~`~l ~`I ~,_r ~q~,.~~, .;~ r~~J _7"~~, ~ F
Prior Lake, MN 55 J'~ 2 Phone: ~/ U- 6~'/~
Date: - 2 ~(- ~ y Time:~~a.mJp.m.
First Inspection ~Second D
Own: ~`" Rent: C~ Age of Home:~
Residential: L~'
Non-Residential: ~
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A. BASEMENT ~'es a No SUMP BASKET ~ 0 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ SiJMP PIJMP ~0 ~ 1 ~ 2 ~ 3 O
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. j
Discharge Point
at Inspection:
~ Laundry tub ~ Sanitary sewer ~ Outside
~ Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
O Home came with system ~ Response to inspection program t7 Other
Q Water in basement ~ Previous system failed
B. ROOF LEADERS: ~s ~ No DISCHARGE: 17 Near C~'Away
C. YARD DRAINS ~ Yes ~''~To WINDOW WELLS O Yes f~' No
BEAVER SYSTEM ~ Yes C1~Id"o
D. PROPERTIES WITH SUMP PUMP5
When does pump run? ~ Fall ~ Summer ~ Spring O Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front 17 Back ~ Side
NOTES:
SUMP PUMP SYSTEM: PASS O FAIL You have 30 days to bring your system into compliance wuh current
regulations. When you are ready for reinspection, call 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~!'1~0
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: (, -1 c~ _
Date: - ? ~/-
Disclaimer: This v[sual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG