HomeMy WebLinkAboutSump Pump Inspection~ ~F PRIp~,
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form ,~~,~~;
Name: l~~C/~•~iG~, ~/~~~~ ~" Date: -'~~'9 Timer~~.1~a.~ni./p.m.
~3 ,/ ~~ ,-- First In~sp~e on L9' Second ~
Address:~~d,7~ /c'/~i~ ~~ ~l~ c.,~.~ ~ Own: L4' Rent: - Age of Home:~~~ 5 t
,/~/ Residential: ~ v A ~ ; ~Ok
Prior Lake, MN 55 ~~~ Phone:'S~'Y ~~~~~Non-Residential: ~ A o Q- o T
'G~'f (... fe~4~L- S P~ ~~~'~,,/
A. BASEMENT [D~'~"es Q No SUMP BASKET 1~ 2 ~ 3 ~
WATER IN BASKET 17 Yes L~.~o ~ 5UMP P ~ ~ 1 ~ 2~ ~~,.~'~~~
WATER IN BASEMENT (flow over floor) ~ Yes ~~,~rO CISTERN O 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 Foint .- ~ Laundry tub ~ Sanita.ry sewer~0 Outside
at Inspection: I~ Floor drain ~ Other
Prior to Inspection: ,,.---
When was system installed, or most recently modi~ed? (Date) and why
~ Home came with system D Response to inspecti on program Q Other
Q Water in basement ~ Previous syste ailed
N
B. ROOF LEADER5:
Q
Yes o
DISCHARGE: ~ Near
~ Away ~
_ _~ . ~
'
C. YARD DRAIN5 ~ Yes No WINDOW WELI.S ~ Yes ~'
No
BEAVER SY5TEM L~ Yes o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front
NOTES:
~~Spring ~ Winter
~...~ack ~ Side
SUMP PUMP SYSTEM: ILYYASS ~ FAIL You have 30 days to bring your system into comp[iance with current
regu[ations. When you are ready for reinspection, call 651 /644-1469 for an app ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~~'No
Where is this location?
This area will need to be~ted~e clear~rate~scharges to the storm sewer system.
Inspector: •
Resident: ~ _. ... _ 1
Date: /~'~O-
Date: /-.,30-
Disclaimer: This vis~al 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: IiRG