HomeMy WebLinkAboutSump Pump Inspection~~ ~F PRIp
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City of Prior Lake
Sump Pump and I/I Reduction
Inst~ection Form
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Name: /~~ ~ G ~J f.-'~~ ~ Dat~`~~~/ Time/~---33`~.m./p.m.
~-''O ~v ~G~ First Inspe ' ~'' Second O
Address: ~a~~~~ ~~~~~'~'~~~C./ 7~ Own: Rent: Age of Home: G~
,` Residential: ~ ~
Prior La~ce, MN 55>1 ~,~J Phone~'`~' ~%2'~~~ Non-Residential: ~
Il,, v~c ~c.- c_--
A. BASEMENT es ~ o SUMP BASKET ~ ~ 2 a 3 ~
WATER IN BASKET es O No SiJMP PU~ 0~ 1 ~ 2~ ~
WATER IN BASEMENT (flow over floor) Q Yes . 1~1o CI5TERN U Yes 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
at Inspection:
~ Laundry tub ~ Sanitary sewerr„l ~ Outside
O Floor drain ~ Other
Prior to Inspection: '" _
Whe as system installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement )~ Pre ' us system failed
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B. ROOF LEADERS: P~~ es ~ N DISCHARGE: ~ Near Away
~ ~ ~~
G YARD DRAINS a Yes ~~ WINDOW WELLS ~ Yes CQ~IQ"o
BEAVER SYS1'EM ~ Yes t~VNo
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall ~ Summer ~ O~ing ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front Q Back O Side
NOTES:
SUMP PUMP SYSTEM: ASS ~ FAIL You have 30 days to bring your system into compliance with current
reguladons. When you are ready,/'or reinspection, cal! 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? O Yes 0~'No
Where is this location?
This area will need to ixe~,sd~~e clear ~r d~rges to the storm sewer system.
Inspector:
Resident: _ , c
Date:
Date:
Disclaimer: Thjs visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG