HomeMy WebLinkAboutSump Pump Inspection~C
~~,
~~'~
~ ~~
~ ~
City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
~P~r
Name:~/~4~t,/~~.!l~.~/ /l ~~i~~~Y~ic~ Dat~~~.~"~g Tim~~.3~.m./p.m.
,.
., ,/ ...~ ~ First In-sp~ on ~ Second ~ r~,. /
Address: ~J'~ 3~'~` ~'~'~N ~~ ~- Q Own: @' Rent: - A e of Home. `~
g ~
y /~ ~~~ ~ Residential:
Prior L,ake, MN 55 ~~~ Phone: ry Non-Residential: ~
~ i /
A. BASEMENT I~'es ~ No~ ~°'~ SiJMP BASKET ~, ~~ 1 ~ 2 ~ 3 ~
WATER IN BASKET 17 Yes I~1Vo SiJMP ,P~_~~ ~J 0~ 1 ~ 2~ ~~'~'~ ~
WATER IN BASEMENT (flow over floor) ~ Yes t~'No CISTERN ~ Yes L~Na
(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 d Sanitary sewer ~ 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 ~ Response to inspection program ~ Other
~ Water in basement ~ Previous sys failed
B. ROOF LEADERS: ~ Yes ~~~ DISCHARGE: ~ Near ~ Awa
Y
C. YARD DRAINS Q Yes Q'~ WINDOW WELi.S Q Yes C9~'No
BEAVER SYSTEM ~ Yes ~~'No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring I~ Winter
(check all that apply) How often does pump run? --
Where does pump discharge to outside? ~ Front ~ Back Q Side
NOTES: -•-•-•- ---•---•-•---------•-•-• - ~-~. --•-•-•-•-• _
SUMP PUMP SYSTEM: L'~PASS ~ FAIL You have 30 days to bring your system into compliance with cunent
regulations. 4Vhen you are ready for reinspection, cal[ 651 /644-1469 for an ap ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~'':~
Where is this location?
This area will need to b xed the clear w ter di charges to the storm sewer system.
Inspector: i'l~~-~ Date: ,,.3 - /-2 - ~
Resident: Date: -/,~Z - ~9
Disclaimer: T' 'sual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all Cit_y Codes.
White: Homeowner Yellow: City Pink: HRG