HomeMy WebLinkAboutSump Pump Inspection` ~) ~F PRtp~
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Inspection Form ,,~~,~Jr
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Name: ./`~~/~/~ ~1~~~ Dat~/-~~' ~~Tir~~~~~Qm./p.m.
`..~ ~ -~ ~~ First In~sp_e ~' n econd ~ ~/
Address:~~ ~~~ ~~~~ ~7~ ~l.~ Own: C~'' Rent: O Age of Home: `~' ~
~ y~ ,~/L/ Residential: ~~ ~
Prior ake, MN 55~/~ Phone:I" "7 ~'~~~ Non-Residential: ~
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A. BASEMENT Lt3^' C~es ~I~~ SiIMP BASKET ~ 0 ~ 2 ~ 3 ~
WATER IN BA5KET ~'Yes Q No SUMP P~~'"~ 0~ 1 ~ 2 ~ 3
WATER IN BASEMENT (flow over floor) ~ Yes ~~ N o 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 ~ Sanitary sewer 17 Outside
at Inspection: ~ Floor drain ~ Other ~
Prior to Inspection:
When s system installed, or most recently modified? (Date)_
Home came with system a Response to inspection program
~ Water in basement ~ Previ system failed
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and why
~ Other
B. ROOF LEADERS: es ~ No DISCHARGE: ~ Near Q~"Away
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C. YARD DRAINS I~ Yes C
f
~N WINDOW WELLS ~ Yes Q
No
BEAVER SYSTEM ,
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~ Yes f~No
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? Q Fall ~ Summer ~ Sprin~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharg e to outside? I~ Front O Back O Side
NOTES:
SUMP PUMP SYSTEM: ~PASS ~ FAIL You havc 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, ca11657/644-1469 for an appo' ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be ed so clear wa~r disc arges to the storm sewer system.
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Inspector: - `" Date: ..~ - / ~ -
' Date: - /
Resident: ~ (~ ~. _
Disclaimer: `fb`is visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
City of Prior Lake
Sump Pump and I/I Reduction
White: Homeowner Yellowc` City Pinkc I~RG '' ;