HomeMy WebLinkAboutSump Pump Inspectionn7
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City of Prior Lake
~~~'~ Sump Pump and
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I/I Reduction
,~ ~~~ ~ Inspection Form
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Name: ~ 0~-~~~~'~ ~~~-' ~ Date: c,.,i -~~' ~~ Time~~a.m./p.m.
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,(~ ~ ,, ,~i~ ~ First In~spe~c '~ ~ ~d ~ ,,/~
Address: 7~~~ ~'~~''v~~~~ v' ~ Own: l~'" Rent: ~ A e of Home: "7'
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~ 7 ~y Residential: ly''~
Prior Lake, MN 55 ~~~''~ Phon~~~"U /~~ Non-Residential: ~
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A. BASEMENT ~s ~o SLJMP BASKET O~ 1~ 2 O 3 O
WATER IN BASKET Lz!'Yes ~ No SUMP P~~ 0~ 1 ~ 2 ~ 3
WATER IN BASEMENT (flow over floor) ~ Yes tL~To CI5TERN Q Yes ~
(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.)
Prior to pection:
Whe as system installed, or most recently modified? (Date)
Home came with system a Response to inspection program
a Water in basement D Previous system failed
B. ROOF LEADERS:
Discharge Point
at Inspection:
Q Laundry tub ~ Sanitary sewer ,~...~7 Outside ~
~ Floor drain C] Other
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and why
~ Other
DISCHARGE: a Near ~ Away
G YARD DRAINS
BEAVER SYSTEM
D Yes ~ No
~ Yes I~~ N/o '~~~
~ Yes Q'No
D. PROPERTIES WITH SUMP PUMP5
WINDOW WELLS ~ Yes ~-3da"'~~
When does pump run? ~ Fall ~ Summer ~ Spring~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? O Front d Back O Side
NOTES:
SUMP PUMP SYSTEM: C~PASS I~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, calt 651i644-7469 for an appointment.
Is there another place where clear water enters the sanitary sewer systein? L~ Yes ~~~
Where is this location?
This area will need to be d so~kg~lear w~ dis~arges to the storm sewer system. _
Inspector:
Resident:'
Date: c,7 " ~o -
Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner
Yellow: CEty ~ , "
Pink: HRG