HomeMy WebLinkAboutSump Pump Inspection3a ~a~ aF PRIp~'
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City of Prior Lake
Sump Pump and I/I Reduction
Inst~ection Form
Name: -~/7 at/ ~~~ ~, ~,~4f~i,~ S~ Date: 3- -/~'9 Time: S. " 50 a. m p. m
~
.~~.~~~ ~ S~ ~~~ ~/~~ 5"'~` First In~sp~ec 'on L~Second a
Address. ~ Own: tg' Rent: Age of Home:1950
Residential: ~
Prior Lake, MN 55 37Z~ Phone: yy~'Z~s~ Non-Residential: ~
A. BASEMENT ~ Yes ~ No / SUMP BASKET ~ 1~ 2 17 3~
WATER IN BASKET ~ Yes l~o SiJMP PUMP ~~'~ Q 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes I~o CISTERN ~ Yes ~-P~'
(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 U Laundry tub ~ Sanitary sewer Q Outside
at Inspection: D Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program Q Other
O Water in basement t~ Previous system failed
B. ROOF LEADERS: ~' Yes ~ No DISCHARGE: ~ Near Away
C. YARD DRAINS t7 Yes ~' WINDOW WELI,S ~ Yes No
A YSTEM t7 Yes ~~" No
BE VER S
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall O Summer 17 Spring a Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? O Front ~ Back Q Side
NOTES:
SUMP PUMP SYST'EM; PASS ~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready for reinspection, call 651 /644-1469 for an a 'ntment.
Is there another place where clear water enters the. sanitary sewer system? 7 Yes ~No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector. Date: 3- y ~/
Resident: " Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not impl_y the structure meets all Cit_y Codes.
White: Homeowner Yellow: City Pink: HRG