HomeMy WebLinkAboutSump Pump Inspection~F PRtp~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
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~} Name: ~~~~~~V /~~/~'JG~~/ig Date: ~ ~~ Time;/~~~a.m./p.m.
9 ~
~ ~ ~'~First In~sp~ec ' '~ C9' Second D
Address: ~~~~~~~~/~C/GtJ04U ~/,G Own: C4'" Rent: Age of Home:
~y ,~/L~.y ~>,~/ Residential: ~
Prior L~ke, MN 55 ~/~ Phone:7"~ /''/~f'~ Non-Residential: ~
. ~.. - ..-- • -..-
A. BASEMENT s~ No ~ SUMP BASKET ~ 1~ 2 O 3 ~
WATER IN BASKET ~ Yes o SiJMP~~L~~V~J,pi'~ 0~ 1 O 2 ~~,3' ~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes E3'~1o
(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~,..., ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to I pection: /
Whe as system installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
Q Water in basement ~~ Pre ous system failed
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B. ROOF LEADERS ~` Yes O No DISCHARGE: ~ Near way
C. YARD DRAINS ~ ~ Yes N WINDOW WELLS ~ Yes ~"~o '
BEAVER SYSTEM ~ Yes o
D. PROPERTIES WITH SUMP PUMPS ~
When does pump run? ~ Fall Q Summer I~ Spring ~ Winter
(check all that apply) How often does pump run? --~
Where does pump discharge to outside? ~ Front Q Back 17 Side
NOTES: ~
SUMP PUMP SYSTEM: '~ASS d FAIL You have 30 days to bring your system into compliance with c ent
regulations. When you are ready for reinspection, call 651 /644-1469 for an pointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to b ed~~ie clear ~er~harges to the storm sewer system.
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Inspector: '
Resident: ; _ (~',w.,r
Date: ~
Date:
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