HomeMy WebLinkAboutSump Pump Inspection.-.~C./ 0~ PRlp~P
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Name: 11 •E/V .
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
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.~~~~ ~ ''/~~/~ Date~~ ~ Time/"~~~.m./p.m.
f %~~ ~'~ First In~spe~c 'on L~''"Second ~
Address:~..,~.~Q~ f'.~'~~~ ~`'7 C'/.~ Own: I~'" Rent~: -°'""Age of Home:~ ~
r~ ,~/ ~i Residential: L~''
Prior Lake, MN 55 ~/~/ Phone-:~`~~ /~ ~ Non-Residential: ~
A. BASEMENT l~'es ~ No~~ ~ SiJMP BASKET ~ 1~ 2 ~ 3 ~
WATER IN BASKET O Yes D~"o SiJMP P 0~ 1 ~ 2_~ ~~~
WATER IN BASEMENT (flow over floor) ~ Yes Q i o CISTERN a Yes E~'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~,... Q Outside
at Inspection: ~ Floor drain ~ Other
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Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program D Other
D Water in basement ~ Prev' s system failed
B. ROOF LEADERS: L~~I'es D No DISCHARGE: 17 Near ~way
C. YARD DRAINS ~ Yes [~~` N/o WINDOW WELLS ~ Yes ~''No
BEAVER SYSTEM 17 Yes ~'No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? Q Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? ,/'"
V~here does pump discharge to outside? O Front ~ Back ~ Side
NOTES: ,.-
SUMP PUMP SYSTEM: ~'ASS ^ FAIL You haVe 30 days to bring your system iruo compliance with current
regutations. When you are ready for reinspection, ca[1651/644-1469 for an ap ' nt.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b~e~ the clea~at~scharges to the storm sewer system.
Inspector:
Resident:
Date:
Date:
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Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG