HomeMy WebLinkAboutSump Pump Inspectionr
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
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r Name: ~~~~~~~'~~K-~ G/~~'~-~'~~1 Date~~~ ~~ Time~~%' a.m./p.m.
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7
~~ ~A J~ ~`~~~ ..,-! ~~' First In~spe~c ° ~ econd ~
Address:~ ~~~ Own: ~ Rent: ~ Age of Home:
~ ~-y~O~ ~ Residential: ~
Prior, Lake, MN 55 ~~~ Phone ~/ Non-Residential: ~~
A. BASEMENT ~Xes ~ No~ SiJMP BAS ~'(~`"1 Q 2 ~ 3 a
WATER IN BASKET ~ Yes o 5iJMP P ~''0 Q 1 ~ 2 O 3
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes o
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B.
C.
D.
NOTES:
(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: Q Floor drain ~ Other
Prior to Inspection: ~
When was systern installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to ins ion program ~ Other
~ Water in basement Q Previous s m failed
ROOF LEADER5:
YARD DRAINS ~
~ Yes No DISCHARGE: ~ Near
Ye NL~"' o WINDOW WELLS Q
s Q Away
Yes ~No
BEAVER SYSTEM 17 Yes d No
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front
~ Sprin~_ ~ Winter
~ Back ~"""" O Side
SUMP PUMP SYSTEM: [~PASS 17 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 ent.
Is there another place where clear water enters the sanitary sewer system? L~ Yes o
Where is this location?
This area will need to b ixed ~ e clear w~ di ges to the storm sewer system.
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Inspector:
Resident:
Date: '~i~ -~ °`~' -
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 Cit_y Codes.
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White: Homeowner Ye11ow: City Pink: HRG