HomeMy WebLinkAboutSump Pump InspectionQF PRIp~
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Insnection Form
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~ Name. ~L.> , Date. /"~' ~~Time~ a.m./p.m.
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,~/` ~ First In~spe~ct° ~ 19~ Second ~
Address:~~~~ ~~~~~ /`~~~~i'~~s Own: f~-'" Rent: ~ Age of Home:~
' / Residential: [~--''~ ,~
PriorLake, MN 55~~~ Phone~`''~~~`~~~~ Non-Residential: D
A. BASEMENT ~i'es ~ No /' SLTMP BASKET I~~~''~0 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes CC9~o SUMP ~P~ ~0 O 1 ~ 2 ~ 3 a
WATER IN BASEMENT (flow over floor) ~` Yes L~No CISTERN ~ Yes ~~
(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 Q Outside
at Inspection: ~ Floor drain 17 Other
Prior to Inspection: .~-
When was system installed, or most recently modi~ed? (Date) and why
~ Home came with system
d Water in basement
B. ROOF LEADERS:
C. YARD DRAIN5
BEAVER SYSTEM
O Response to inspection program a Other
~ Previ us system failed
I~Yes ~ N DISCHARGE: ~ Near 1~'Away
~ Yes ~~_~~ WINDOW WELLS O Yes ~ No
~ Yes f~d'' No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
Q Spring a Winter
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Q BaCk la 5ide
SUMP PUMP SYSTEM: ~3~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, ca11651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? C] Yes ~-^iVo
Where is this location?
This area will need to ixe o e clear w~r~i~harges to the storm sewer system.
Inspector:
Resident~
Date:~ % ~~-
Date: '7`' ~
Disclaimer: This visual inspection is done wi due diligence to find obvious clear water cross-connections
and does not im 1 the structure meets all t Codes.
White: Homeowner Yellow: City Pink: HRG
City of Prior Lake
Sump Pump and IiI Reduction