HomeMy WebLinkAboutSump Pump Inspection,-<~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~ ~ ~-~,
Name: ~,qr.;an, k°~,v,mf~ ~ L~<~~~r~
Address: ~,,2 ~ 7 ~~ r' ~ ; y~ V~.~ 6 ~ C / ~ ~ ~
Prior Lake, MN 55 7~ Phone: ~`~1,~-.~30 ~
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Date: ~/-.2~/- ~y Time:~a.m./p.m.
First Inspection l3~
Own: I~' Rent: ~
Residential: L~
Non-Residential: L7
Second ~
Age of Home:~
j~,! a_ I 6, u N r
A. BASEMENT L~Yes ~ No SLJMP BASKET ~~~ 1~ 2 ~ 3 ~
WATER IN BASKET I~ Yes L~'~1o 5iJMP PUMP C~T 0 Q 1 ~ 2 a 3 O
WATER IN BASEMENT (flow over floor) ~ Yes ~"No CISTERN ~ Yes ~'No
(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 17 La.undry tub Q Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system D Response to inspection program ~ Other
~ Water in basement D Previous system failed
G V l ~ 4 ~
B. ROOF LEADERS: ~ l~Yes t7 No DISCHARGE: ~Near O Away
C. YARD DRAINS ~ Yes C~'1~1o WINDOW WELLS ~ Yes C-f''~To
BEAVER SYSTEM ~ Yes ~' No
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? O Fall ~ Summer O Spring O Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? 17 Front ~ Back ~ Side
NOTES:
Inspector: ~ ~~'1 5>' Date: ~/- .:~ ~/- 9 ~
Resident: _q~,~ Date: ~/ - -2 ~/~ 9 9
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SUMP PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca11651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~ No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
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