HomeMy WebLinkAboutSump Pump Inspection~yl,~' ~F PR1p
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City of Prior Lake
Sump Pump and IiI Reduction
Inspection Form ,~,~,~J~
Name: /~~/•S',CC•t,/, ~C,~!'A.C".L
Date:' ~ `~ ~ ~
Time~~. m. /p. m.
,~ ~ ~y .-- First In~~spe~c '~ @-'" Second ~
A~~ress: ~~lO ~i4/~c./GJ04+D C.,,, /.~ ~~ ~~,n: ~'" Rent: ~ , A~e of Home:~~
~~~..,~ , /_ /~~~~,~,9 Residential: ~'~ ~
Prior Lake, MN 55 ___ Phone `~`~~` Non-Residential: ~
A. ~ BASEMENT ~es ~ No~~~ SUMP BASKET ~ 0 ~ 2 ~ 3 ~
WATER IN BA5KET ~ Yes D~o SiJMP P~UM~P~ ~ 1 ~ 2_ ~ ~3
WATER IN BASEMENT (flow over floor) a Yes L"~- P~ o CISTERN ~ Yes ~- I d' 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 ~ Sanitary sewer ,--- l7 Outside
at Inspection: I~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
~Home came with system ~ Response to inspection program
O Water in basement ~ Previous system ailed
~ Other
and why
ROOF LEADERS: 17 Yes ~~Q"o DISCHARGE: ~ Near ~ Awa
B. y
C. YARD DRAIN5 ~ Yes ~_~iQ!~''~ WINDOW WELL5 ~ Yes ~'PO
BEAVER 5YSTEM ~ Yes Q'No
D. PROPERTIES WITH SUMP PUMPS
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 ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: C]~ASS ~ FAIL You have 30 days to bring your system into comp[iance with cutrent
regulations. When you are ready for reinspection, cal! 651 /644-1469 for an appoitttment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes 4.7- P~Fv"''r~
Where is this location?
This area will need to xe e clear ~r d~harges to the storm sewer system
Inspector:
Date:
Date:
_i-
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