HomeMy WebLinkAboutSump Pump Inspection~ ~~ PR.~p
~ ~ ~
~~~ ~ ! ° ~ ~
,~~~
~
City of Prior Lake ~`~-~~
Sump Pump and I/I Reduction
ection Form ,~,~P ~,-
Name: ~~/~~ ~~~ ~~ ~7~~ Date~"'7" ~,~ Time~1o~ a.m./p.m.
,~
~q ~,~/ ~'~ ~~ First Ins ion 9'" Second Q
Address: ~~r' ~~~~ /`~~~~ ~~ Own: ~ent: Age of Home: ~ 3
,~/,/ Residential: ~ ~
Prior Lake, MN 55 ~~.~" Phone:~`'`~` ~'~ ~i ~ Non-Residential: ~
, ~ ~
A. BASEMENT I~'Yes O No 5iTMP BASKE L9~'~ 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o SiJMP P e' 0~ 1 ~ 2~ ~~~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes ~'No
(If no pump, place sticker across edge of surnp cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form. )
Discharge Point
at Inspection:
~ Laundry tub O Sanitary sewer _,,,._.,. Q Outside
~ Floor drain a Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
~ Home came with system I~ Respons to inspection program ~ Other
~ Water in basement ~ Prev' s system failed
B. ROOF LEADERS: ~ No DISCHARGE: ~ Near Aw
p ~~~~
C. YARD DRAINS ~A ~"~ Yes ~ ~N WINDOW WELLS es C~ No
BEAVER SYSTEM ~'4 'G~ Yes dN'No
O~ y41s ~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall ~ Summer ~ S~ring Q Winter
(check all that apply) How often does pump run?
V~Fhere does pump discharge to outside? C7 Front ~ Back Q Side
NOTES:
SUMP PUMP SYSTEM: C~j~ASS O FAIL You have 30 days to 6ring your system into compliance with curre
regu[ations. When you are ready for reinspecdon, call 651 /644-1469 for an ap ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be e~he clear~te~scharges to the storm sewer system.
Inspector: ~ / Date: .~- "~'-
Resident: ,. ~,..., /~ . ~~,~,.~~---- - 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
, ~`
~:; ~ ...~ ~
,~ <~~ ~ E-
of Prior
A.
B.
C.
D.
Reduction
tion Form
BASEMENT Yes Q No SiJMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BAS T Q Yes ~ No SUMP PUMP ~0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) Q Yes~ No CIS RN L'a Yes ~ io
/\
(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 O Sanitary sewer ~ Outside
at Inspection: l~ Floor drain ~ Other
Prior to Inspection: - ,;~.* ..
When was system installed, or most recently modifiec~~ (Dat~~ ~• y'~~ ,~~ f~,,; ~and v~~~'
~ r
¢
~ Home came with system Q Response to inspection program ~ Other
~ Water in basement I~ Previous syste~a failed
ROOF LEADERS: ~Yes ~ No DISCHARGE:~"~1'ear I"~Away
YARD DRAIN5 ~ Yes No ~. WINDOW WELL5 ~Yes ~~ No
BEAVER SYSTEM t~ Yes No ~`
_`
,~;,;~~
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here doe~ pump discharge to outside? ~ Front ~ Back D Side
NOTES:
This area vy~i'nee to b~fixed so the clear water scha ges to the storm sewer system.
~
SUMP PUMP SYSTEM: ~PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? a Yes No
Where is this location?
--..,r.,.,..,_ .
Resident:
Date:
Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG