HomeMy WebLinkAboutSump Pump Inspection~F PRIp~,
~~~ ~~ ~
~ ~ ~
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~~~~r
Name: ~~/~~~~.C.~ ~, l~V/~ ~~~J'~ Date:~i2'7 Tim~~~mJp.m.
.
~/ / ~} '~'~ First Inspe ' n L9~ Second ~
Address: ` y~~/ ~/~~~~~~ l..r~~ Own: Rent: Age of Home: ~~~Q
~l ,~fL~l,~/ Residential: ~ J
Prior L~ke, MN 55 ~~~v Phone.:J"T ~I ~'~~~ Non-Residential: ~
A. BASEMENT C~es ~ No~~ 5iJMP BASKET ~~ Q 1 ~ 2 ~ 3 CJ
WATER IN BASKET I~ Yes ~'No SiJMP P~ ~A" 0~ 1 ~ 2~ ~~ ~
WATER IN BASEMENT (flow over floor) O Yes ~a'No CISTERN ~ Yes G3'1Vo
(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 ~ La.undry tub ~ Sanitary sewe~ a Outside
at Inspection: ~ 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 -
O Water in basement ~ Pr ous system failed
B. ROOF LEADERS: ~ Ye No `;;DISCHARGE: ~ Near ~Away
~~j G~ ~ ~~
C. Y A R D D R A I N S '~~ Y e s ~~ ~N ~ W I N D O W W E L L S Q Y e s E~" N o
BEAVER SYSTE yy~ ~j ~~ f~ Yes L 9' N o
J
D. PROPERTIES TH SUMP PUMPS
When does pump run? t~ Fall ~ Summer O Spri~._ Q Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front O Back r.- Q Side
NOTES:
SUMP PUMP SYSTEM: ~AS5 O FAIL You have 30 days to bring your system into compliance with rrent
regulations. When you are ready}'or reinspection, call 651/644-1469 for appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes No
Where is this location?
This area will need to be ed ~a ~ d~rges to the storm sewer system.
Inspector:
Resident:
Date: ~ -ti '
Date: ~~
Disclaimer: This visu inspection is done with due diligence to find obvious clear water cross-connections
and does not impl_y the structure meets all Cit_y Codes.
White: Homeowner Yellow: City Pink: HRG