HomeMy WebLinkAboutSump Pump Inspection1 aF PRI p~P
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City of Prior Lake
Sump Pump and I/I Reduction
ction Form ~1,~,~ J ~-'
Name: ~ / ~v, ~~'~'~~~ Da~~~l~~Ti~Q~d a.m./p.m.
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.i'~ ~~ ~~First In~s~ o~n Cc!-''Second ~
Address: ~~~1'~/~/~'~,/gGtlit/ ~i~iO.G•C.~ Own: Pl Rent: Age of Home:~
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~y /,~ Residential: ~
Prior Lake, MN 55 ~/~ Phone~, ~' ~-•~~d ~ Non-Residential: ~
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A. BASEMENT ~ s Q No / SUMP BASKET ~'" 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes L7'No SiJMP P~M 0~ 1 ~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes ~'No CISTERN ~ Yes ~
(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 O Sanitary sewer ~ Outside
at Inspection: Q Floor drain ~ Other
Prior to Inspection: --'"
When was system installed, or most recently modified? (Date) and why
Q Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Q Previous system failed
B. ROOF LEADER5: j'~I~ Yes I~No DISCHARGE: ~ Near ~ Away
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C. YARD DRAIN5 ~ Yes Q_" ~N,!'' WINDOW WELLS ~ Yes D~'No
BEAVER SYSTEM ~ Yes ~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer I~ Spring ~ Winter
(check all that apply) How often does pump run? ~
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES: ~--- ---._._.-•-•-•-•- ------- -----------•-------•-----•-•-•-•-•-•-------~r.-•- --- -------------•- - -•-----------•-
SUMP PUMP SYSTEM: ~i'~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appo' t.
Is there another place where clear water enters the sanitary sewer system? Q Yes o
Where is this location?
This area will need to ixe~e clear w~er di~arges to the storm sewer system.
Inspector;
Resident:
Date: ~ - f 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