HomeMy WebLinkAboutSump Pump Inspection~F PRIp~
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City of Prior Lake
Sump Pump and I/I Reduction
ion Form
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Name: / ~Gf ~ ~~~i~
~~'~~~ ~r~~~~~"~
Address:
Prior Lake, MN 5~~~/ Phone~d7 /" /~~
Dat1a: ~~~1- ~~ TimeJ. ~ 7~a.m./p.m.
First In_spe~ct' ~ C]" Second O
Own: C4~'" Rent: Age of Home:~=~ `
Residential: ~ ~,
Non-Residential: ~
A. BASEMENT ~es ~ No~ SUMP BASKET t~J'~~CM 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o SUMP P ~0 ~ 1 ~ 2-~~ ~ ~3
WATER IN BASEMENT (flow over floor) ~ Yes o CI5TERN ~ Yes L~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. )
Discharge Point ~ Laundry tub O Sanitary sewer,,~ Q Outside
at Inspection: O Floor drain ~ Other
Prior to Inspection: ~
When was system installed, or most recently modified? (Date) and why
~ Home came with system
Q Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
~ Respo e to inspection program ~ Other
~ Pr ous system failed
Yes ~ No DISCHARGE: Q Near Away
~ Yes ~~~~ WINDOW WELLS ~ Yes L'9''No
~ Yes L~' No
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? Q Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
~ Spring ~ Winter
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~ Back ~ Side
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SUMP PUMP SYSTEM: ~jPr~SS O 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 nt.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~
Where is this location?
This area will need to ixe I e clear ater~ischarges to the storm sewer system.
Inspector: •
Resident: _ _.,,~.~
Date: „~ "
Date: ~-
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG