HomeMy WebLinkAboutSump Pump Inspection4 aF PRjo
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form , ~,~~-~ ~
Nam~e: ~1~~,~~i~,C..~~it~~~G~~ /'~. Date~~~"~~ime~~~~.mJp.m.
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/~ ~y~/ First In~sp~e ' n ~7" Second ~
Address: ',~'~/ ,~"/ N7~S Own: ff~'" Rent: Q--~Age of Home~~~
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' Residential: ~.
Priq~r Lake, MN 55~~~ ~ Phone`.~~ ~ Non-Residential: ~
A. ' ASEMENT ~~a No~ ~ SUMP BAS T ~ 1 ~ 2 O 3
~ WATER IN BASKET l7 Yes C~YNo SiJMP P 0 O 1 ~ 2 ~ Q
4 ~
,~ WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes o
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;` (If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
i break seal. Skip to Part B of this form. )
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! Discharge Point ~ Laundry tub Q Sanitary sewer ~ Outside
~ at Inspection: l~ Floor drain ~ Other `~
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Prior to Inspection:
- When was systern installed, or most recently modified? (Date) and why
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i` Q Home came with system ~ Response to inspection program d Other
~ ~ Water in basement a Previ system failed
~. ROOF LEADERS: es ~ No DI5CHARGE: ~ Near C~
~. YARD DRAINS D Yes ~~N~o WINDOW WELi.S ~ Yes ~t~o
j BEAVER SYSTEM ~ Yes a.~fo
D. PROPERTIES WITH SUMP PUMPS ,~
When does pump run? O Fall Q Summer ~ Spring ~,,.~.~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? l7 Front ~ Back D Side
NOTES: •---•-•---•-•---•-•--- ---•---•-•-•-•-•-•-•-•---•-•-•-•-•-•-•-•-•---•-•---•-•---•- ---•-------•- -•-•-----•-----._
SUMP PUMP SYSTEM: L~/PASS ~ FAIL You have 30 days to bring your system into comp[iance wuh current
regulations. When you are ready for reinspection, call 657 /644-1469 for an ap ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~~~
Where is this location?
This area will need to be fixe~ th~ear wate~isch~es to the storm sewer system.
Inspector: Date: ' O -
Resident: ,~,, Date: O -
Disclaimer: This visual inspection is done with dne diligence to find obvious clear water cross-connections
and does not imply the structure meets all Cit Codes.
White: Homeowner Yellow: Ci,ty Pink: HRG