HomeMy WebLinkAboutSump Pump Inspection~ ' L. J ~F PR1p
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name:~/~ ~, ,~~ ~ /~
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Address: ~~~ ~~'~/~C/Gc/OD,f~ ~/,~
Prior Lake, MN 55 ~~i/ Phone~7`~ ~~(o,~`
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Date:~ ~~~ Time.~~~.ar.m./p.m.
First In~sp~ec ' n A' Second O
Own: C4'" Rent: /~ Age of Home:~~
Residential: I~' ~
Non-Residential: D
~~ ~.v c.~.. c~ ,c.~ c,~.. •
A. BASEMENT es O No~ SiJMP BASKET ~1 1~ 2 ~ 3 O
WATER IN BASKET ~ Yes No SUMP~PUM~- ~~ 1 ~ 2 ~ 3~
WATER IN BASEMENT (flow over floor) ~ Yes 1'-1'~o CISTERN ~ Yes C~-~~
(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: ~ Floor drain ~ Other
~
Prior to Inspection:
When was system installed, or most recently modified? (Date)
~ Home came with system ~ Response to inspection program
~ Water in basement I~ Previ system failed
and why
~ Other '
B. ROOF LEADER5: es C] No DISCHARGE: ~
C. YARD DRAINS l~ Yes~ N~o/ WINDOW WELLS
BEAVER SYSTEM ~ Yes m~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
Near ~`?{"way
L~~Yes O No
Q Spring L7 Winter
Q Back D Side
SUMP PUMP SYSTEM: [3?'ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appo nt.
Is there another place where clear water enters the sanitary sewer system? Q Yes L~#"TTo
Where is this location?
This area will need to be f ed s e clear w r' harges to the storm sewer system.
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I Inspector: . :.~~~ `"`' ." ""'"" Date: ,~ ' "''>' - 7 7 I
Resident: ,~ ;/,~ ,y% ~;,~~,,v ; y i' ,~ ' Date: ~
Disclaimer: This visual inspecNon 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