HomeMy WebLinkAboutSump Pump Inspection~ 4F PRlp
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form ,r-~~,~,~J~
Name: fv~~~'" ~ cL/F/~'(~~ Date:~~ "~~ Time,~~a.m./p.m.
~ ~ `~'~ First In_~s~p~e 'on A''" Second Q
Address:,~~~~1" /~i~ / G'/~t/ ~/~(~ Own: ~Y° Rent: /~ Age of Home: ~~
,/ Residential: L~'' ~
Prior Lake, MN 55 ~~~ Phone~''7' ~~~ ~~ Non-Residential: ~
A. ' BASEMENT es Q No~ SUMP BASKE ~'0~ 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o 5iJMP P ~''~0 Q 1 C] 2 Q 3
WATER IN BA5EMENT (flow over floor) ~ Yes o CISTERN ~ Yes o
(If no pump, place sticker across edge of surnp cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point ~ La.undry tub ~ Sanitary sewer „_,~,~7 Outside
at Inspection: ~ Floor drain Q Other
Prior to Inspection: /'~
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Respo e to inspection program ~ Other
~ Water in basement O Pre ' us system failed
B. ROOF LEADERS: Yes L7 No DISCHARGE: Q Near wa
Y
C. YARD DRAINS D Yes WINDOW WELLS Q Yes I~~o
BEAVER SYSTEM ~ Yes o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? Q Fall O Summer ~ Sprin~,...--~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? 17 Front Q Back O Side
NOTES:
SUMP PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance with ent
regulations. When you are ready for reinspection, ca[[ 651/644-1469 for an pointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be fi so t clear wa r di arges to the storm sewer system.
Inspector: . Date: '
Resident: .~'~~'j , ~'~ n Date: -
Disclaimer: This visu~rl' inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all Cit_y Codes.
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White: Homeowner Yellow: City Pink: HRG