HomeMy WebLinkAboutSump Pump Inspection`~' ``" ~ ~ ~' ~'~ Oc~ '~.
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
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Name : ~ ( !.~l~/',~ G. ,(~~-,% ~Q ~ .
Address: ~,~o~~D~ ~Sf,~' %t~in~T ,L7 ~(G..
Prior Lake, MN 55 Phone:~~ ~/j'a ~'
Date: t7 /f- y'" Time:,~,~0 a. ./p.m:
First Inspection ~ Second ~
Own~ Re t: ~ Age of Home:~
Residentia~
Non-Residential: ~
A. BASEMENT ~Yes ~ No SUMP BASKET ~ 0,~ 1~ 2 ~ 3 17
WATER IN BASKET ~ Yes ~No 5iJMP PiJMP ,~ 0~ 1 ~ ~ 3 17
WATER IN BASEMENT (flow over floor) O Yes ~o CISTERN Q 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 Point ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
B.
C.
D.
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previ s system failed
,C ~-,,~ ~. ,~e',eo,~r- ~ S . a ~
ROOF LEADER5: ~ Ye ~No DISCHARGE: ~ Near ~ Away
YARD DRAINS ~ Yes ~ No WINDOW WELLS ~ Yes ~~ No
BEAVER SYSTEM ~ Yes~ No
PROPERTIES WITIi 5UMP PUMP5
When does pump run? ~ Fall ~ Summer ~ Spring Q Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? 17 Front O Back O Side
NOTES:
SUMP PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[l 651 /644-1469 for an appointment.
Is there another place w er clear water enters the sanitary sewer system? ~ Yes No
Where is this 1 ation
This are ill n t xed so the clear w r' charges to the storm sewer system.
I ect • Date: 0 -- -g'
Resident: . Date:
Disclaimer: This visual ins~i6n is done with due diligence to find obvious clear water cross-connections
and does not implv the structure meets all City Codes.
White: Homeowner Yellow; City Pink: HRG
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