HomeMy WebLinkAboutSump Pump Inspection1
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City of Prior Lake
Sump Pump and IiI Reduction
Insnection Form
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Name: Z.1 U .(./SO~ '""
~ l~e~,~',E'.~'~c.~ Datc~:~-~ Tim~! /'~aa.m./p.m.
~~~~ / // n First In~sp~ec ' n ~cond ~ 2
Address: /~~"1u~O /~'/~r/.E J5'~~~ ~~V~Own: I~'' Rent: ~ Age of Home:~o1 A
,/,/ Residential: L~'~ ~
Prior Lake, MN 55 ~~i~ Phon~`~`'~` ~ 9~~ Non-Residential: ~
A. BASEMENT ~ Yes ~I~Pdo~ ~ SiJMP BASKET 1~ 2 O 3 O
WATER IN BASKET d Yes @'No SiJMP_ _P~UM~ 0~ 1 ~ 2~ ~~'~
WATER IN BASEMENT (flow over floor) ~ Yes C l?~ o CISTERN ~ Yes D T 1 o
(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 was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other ~
Q Water in basement ~ Previous sy failed
B. ROOF LEADERS: ~7 Yes No DISCHARGE: ~ Near a Away
G YARD DRAIN5 ~ Yes ~~ ~N WINDOW WELL5 O Yes A'1~To
BEAVER SYSTEM ~ Yes l9~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spr~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Bac~c- 17 Side
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NOTES: U ~~.~ O~ ~A~~'
SUMP PUMP SYSTEM: L~J YASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[[ 651 /644-1469 for an ra.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to b~fixe~o the clea~ wat~discharges to the storm sewer system.
Inspector:
Resident:
Disclaimer: This visual inspection is done with dne diligence to find obvious clear water cross-connections
and does not imply the structure meets all City Codes.
Date: ...1--c -~'
Date: ~3-•Z3 -
White: Homeowner
Yellow: City
Pink: HRG