HomeMy WebLinkAboutSump Pump Inspection Programr~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,r~,~~
Name: .~~~~~ ~~ ~~~~ Date~f~~ "~.9 Time~~a.m./p.m.
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Q~, > / ~~ First InsP ~tion 19~" Second Q /
Address: ~C~v,j ,~.C~.~~/ ~~ ~7~ ~i~' Own: I~' Rent• A e of Home: I K~
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,/'/~, '/ Residential: ~
Prior Lake, MN 55 ~7i~/ Phone~`a`'~/''`~''~~~ Non-Residential: C1
I Vl.~•-Y \..~ .v
A. BASEMENT es Q~io SUMP BASKET ~ 1~ 2 ~ 3 ~
WATER IN BASKET 4YrYes ~ No SUMP PI~IP 0~ 1 ~ 2~ ~
WATER IN BASEMENT (flow over floor) ~ Yes ~No CI5TERN ~ 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 I~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other --
~ Prior to nspection: ~
Whe as system installed, or most recently modified? (Date) and why
Home came with system D Response to inspection program ~ Other
O Water in basement ~ Previous sy m failed
B. ROOF LEADER5: ~ Yes L~~~~1 DISCHARGE: ~ Near O Awa
Y
C. YARD DRAINS O Yes ~~~~~~ WINDOW WELLS ~ Yes 19~No
BEAVER SYSTEM ~ Yes @~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer O Sprin~ ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside7 ~ Front ~ Back O Side
NOTES:
SUMP PUMP SYSTEM: C4~PASS ~ FAIL You have 30 days to bring your system into compliance with rrent
regulations. When you are ready}'or reinspection, ca11651/644-1469 for pointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be~yFke~the cle~wa~ discharges to the storm sewer system.
Inspector:
Resident:
Date: ,.G ~/ro-
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 Yellow: City Pink: HRG