HomeMy WebLinkAboutSump Pump Inspection~J~
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
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~ Name: ~ ~:_...~'r~ / ~
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-~~`~~ TimeY`~~a.m./p.m.
~~1~ /~ ~irst Inspection ~nd ~ 2~!
Address:'7'/"7~ ,%~~?/~.~~~/~d,4 C.~.~•e ~'~- Own: ~Rent: 0 Age of Home:~JJL
//,/ Residential: ~ `
Prior Lake, MN 55~ Phone~'~` ~~~ Non-Residential: ~
A. BASEMENT ~s a No ~/ SiJMP BASKET ~ 1 ~ 2 Q 3 ~
WATER IN BASKET ~ Yes ~/No SiJMP PU~ 0~ 1 ~ 2~
WATER IN BASEMENT (flow over floor) d Yes [~'l~To 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
at Inspection:
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 /,,Prev' s system failed
B. ROOF LEADERS: ~~ [~Yes Q No DISCHARGE: ta Near 1~"Away
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C. YARD DRAINS ~ Yes l~' N~- WINDOW WELLS s~ No
BEAVER SYSTEM t7 Yes [IYNo
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
~ ~ing ~ Winter
~ Back ~ 5ide
SUMP PUMP SYSTEM: t~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[[ 651 /644-1469 for an appot ent.
Is there another place where clear water enters the sanitary sewer system? L~ Yes ~~1Vo
Where is this location?
This area will need to be ed e clear w~r~arges to the storm sewer systet~n.
Inspector: • ~='~'~``~' Date: '~`~- ~a - ~ 9
Resident: ,~ Q ~,.~~ Date: -~.G- i o-~~_
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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.
O Laundry tub ~ Sanitary sewer ~ Outside
Q Floor drain ~ Other
White: Homeowner Yellow: City Pink: HRG