HomeMy WebLinkAboutSump Pump Inspection4F PRIp~
/M1 ~ ~~ `~ : ~
~; ~~ ~
~ ' ',• ~'
~
,
City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name:,/; ~i ~ ~!~(/D~ 7~~ / `/ ~,~' ~.E Date~~~~" ~ Time,~~7 ~7a. m. /p. m.
,(/ ~>/ i ~,~ ~ /I/~ ~~-First In,sp~ on Y Second ~ ~
Address:7'~e~ ~,~ L~~ C.~ Own: t9' Rent: Age of Home. ~ ~
~// Residential: ~ ~
Prior Lake, MN 55~.~ ~C,~i Phone~~7 '~'~~ Non-Residential: ~
~ ~.~.. -~, ~,..
A. BASEMENT es ~ No~ BUMP BASKET ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET (7 Yes o SUMPC~'U,~ ~ 1 ~ 2~~
WATER IN BASEMENT (flow over floor) D Yes '~io 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 ~ Laundry tub f~ Sanitary sewer ~, !7 Outside
at Inspection: ~ Floor drain ~ Other
B.
C.
D.
NOTES:
Prior to Inspection:
When was system installed, or most recently modified? (Date)
~ Home came with system
O Water in basement
ROOF LEADER5:
YARD DRAINS
BEAVER SYSTEM
/
i
and why
~ Response to inspection program ~ Other
~ Prev' us system failed
es ~ No DISCHARGE: ~] Near ~T Away
~ Yes ID~~~N '' WINDOW WELLS ~ Yes No
~ Yes IYNo
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
~ ~ing ~ Winter
~ Back ~ Side
SUMP PUMP SYSTEM: Q~ASS ~ FAIL You have 30 days to bring your system into compliance with c ent
regulations. When you are ready for reinspection, cal[ 651 /644-1469 for ppointment.
Is there another place where clear water enters the sanitary sewer system? O Yes No
Where is this location?
This area will need to ix~ the clear~at~ischarges to the storm sewer system. _
Inspector:
Resident:'
Date: ~G S-
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
`Ye11aJv: :City
Pink: HRG