HomeMy WebLinkAboutSump Pump Inspection~1
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
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Name:~ ~~~~~~~"'.C-.C,.C.l.~~ `~~~.~~ Date:" 7'~~~ ~~ Time:~e'~~Oa.m./p.m.
~ /~ First Ins~p~ec ° ~ [~ Second D ~
Address: /~~C ~~~/~~~~~~ C,~~/,~' ~.~ Own: L~" Rent: - Age of Hame~
'/ Residential: ~ ~
Prior Lake, MN 55 ~~ Phone~~" ~~~~~° Non-Residential: ~
A. BA5EMENT dY~es ~ No SUMP BASKET ~~~ 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~~ SUMP P~~ t~0 D 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) Q Yes L~~1Vo CISTERN O Yes 4Z~cr~
(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 a Laundry tub O Sanitary sewer a Outside
at Inspection: ~ Floor drain ~ Other
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Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
B.
C.
D.
NOTES:
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previo ystem failed
ROOF LEADERS: es I~ No DISCHARGE: ~ Near way
YARD DRAINS ~ Yes WINDOW WELLS O Yes L7'No
BEAVER SY5TEM ~ Yes o
PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall L~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
O S,pring CI Winter
l~ Bae~k ~ Side
SUMP PUMP SYSTEM: ~ASS a FAIL You have 30 days to bring your system into compfiance with cu
regulations. When you are ready for reinspection, ca[l 651 /644-1469 for an ointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b ec~he clear v~te~charges to the storm sewer syste~.
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Inspector~--'"'7 •
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Resident: ~, ~ .s~,.,.~.-
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 imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG