HomeMy WebLinkAboutSump Pump Inspection~F PRIp~ . ~~ ~
~`~ ~ ~ ~ City of Prior ~~L~,ke
Sump Pump and I/I ~eduction
Inspection For~n
Name: ~C~ ^ ~ 1,,,~y ~ Date: -1• `~'~ Time: ~; o~ .~r ./p.m.
`` First Ins
Address: 3~ 5`~ G~ Q~~ t~Q~ y~~'s -~k t~,~ 5, Own:1~. ection ~ Second ~
Rent: ~ Age of Home:
Resident al: ~
Prior Lake, MN 55 Phone: Non-Res 'dential: ~
A. BASEMENT ~ Yes ~No SUMP BASKET ~ 0 ~ 1 C7 2~ 3 ~
WATER IN BASKET O es ~ No SiJMP PUMP ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) 17 Yes ~ No STERN ~ Yes 17 No
(If no pump, place sticker across edge of sump cover and baseme t floor so any removal of cover will
break seal. Skip to Part B of this form. )
Discharge Point ~ Laundry tub Q Sanita y 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 ~ Response to inspection progra ~ Other
C] Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHA GE: ~ Near tl Away
C. YARD DRAINS ~ Yes ~ No WINDO WELLS ~ Yes~ No
BEAVER SYSTEM ~ Yes D 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? ~ Front Q Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ PASS ~ FAIL You have 30 days t bring your system into campliance wuh current
regulations. When you are ready for rei pection, catt 6511644-1469 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 ewer system.
Inspector: '1~ D te: ~~ 2- 9 q
Resident: ~ D te: ~. -'2.- G`1
Disclaimer: This visual inspection is done with due diligence to find o vious clear water cross-connections
and does not im 1 the structure meets all Cit Codes.
White: Homeowner Yellow: City ~ Pink: HRG