HomeMy WebLinkAboutSump Pump InspectionU~ aF pRro
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~,~,~'~'
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Name: /~D~~C:~•~, /~',~i~~,~.~G'~ ~ Date~~~'~J~~~ Tim~~a.m./p.m.
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,~~, ~~~ ` ;~7, ~ ~~ First Inspe ' ~-''~econd ~ ~~~
Address: ~i~~ r/ ~" !„~ Own: Rent: ~ ge of Hom
, ./ ,~ Residential: ~ ~
Prior Lake, MN 55 ~~i~ Phone ~'~`c• J~91i Non-Residential: ~
A. BASEMENT ~es ~ No~~~ 5ITMP BASKET ~ 1 Q 2 ~ 3 ~
WATER IN BA$KET I~ Yes L~'No SUMP P~~' 0~ 1 ~ 2_ ~~ ~
WATER IN BASEMENT (flow over floor) ~ Yes f~~'No CISTERN ~ Yes L~Qo
(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 sewgr„ ~ Outside
at Inspection: ~ 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
~ Water in basement ~ Prev' system failed
B. ROOF LEADERS: YL~~ es Q No DISCHARGE: Q Near way
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C. YARD DRAINS ~Pu~~tiG~ ~I'es ~~,_ ~N ~''~ WINDOW WELI.S t9~Yes ~ No
BEAVER SYSTEM ~ Yes ~No
D. PROPERTIES WITH SUMP PiTMPS
When does pump run? 17 Fall ~ Summer ~ Spri~g_..._ ~ Winter
NOTES:
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back
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SUMP PUIVIP ~YSTEM: @~PASS I~ EAIL You.have 30 days to bring your system into compliance with current
regulatiorrs. When you are ready for reinspection, cal[ 651I644-1469 for an ' ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b ~the clea~~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 imply the structure meets all City Codes.
~ Side
White: Homeowner Yellow: City Pink: 'FiRG