HomeMy WebLinkAboutSump Pump Inspection~ ~~
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~`~ ~ City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~,~~~
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Name: /~~ ~~~~9~1~, (,~i~~(//.E~,(~ Date~"'7' ~ Tim~~~.m./p.m.
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,~' --~'""~ /~'~ First In,~s~p~e '~n Second ~
Address: ~,,"J~Q~D ~~~ 7~ ~~C., /~ Own: L~' Rent: ~ Age of Home:~
~~ , /~~~/Q~ Residential: ~'"~ J
Prior Lake, MN 5 ~ Phone~~ Non-Residential: ~
A. BASEMENT ~'S'es ~ No / SiJMP BASKET l~_~~"0~
' 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~'Go SiJMP
P~ ~
0 Q 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) ,
~ Yes i~'No CISTERN ~ 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 ~ Laundry tub ~ Sanitary sewer D Outside
at Inspection: O 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
~ Water in basement I~ Pre 'ous system failed
B. ROOF LEADERS: Yes ~ No DISCHARGE: ~ Near ~'Away
C. YARD DRAINS ~ Yes WINDOW WELLS Ca Yes B"No
BEAVER SYSTEM d Yes No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer ~ Spr.i~g CI Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front ~ Back ~ Side
•-•-------•---•-----•-------•-•- -•-•-•-•-•-•---•-----------~--•-----•-•-•-•-•-•-----•-------
NOTES:
-/J ___ _ ___
SUMP PUMP SYSTEM: L'X~ASS ~ FAIL You have 30 days to bring your system into compliance with current
reguladons. When you are ready for reinspection, cal[ 651 /644-1469 for an otntment.
Is there another place where clear water enters the sanitary sewer system? O Yes D/No ,
Where is this lo ion?
This area will n~ed;t~be ~d so clear ~~arges to the storm sewer system. ~
Inspector: ~ Date: ~ - '~'"
Resident: . ~ n ~ Date: ~~
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
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