HomeMy WebLinkAboutSump Pump Inspection~ ~ 4F PRIp
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form ,~,~~~ ~
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Name: ~/~~ 1 ~~•1.- ~ Date:~`~~ ~~ TimeC/~~~m./p.m.
,f/ ~~ First Ins~p~ec ' ~ ~ond I~
Address:1~~7 /~0~~~~~f~ ~/~ Own: I~'" Rent: Age of Home:~ ,
,~/`/.y Residential: ~ ~
Prior Lake, MN 55 ~~i~ Phone:l'~` /'~~~~ Non-Residential: ~
A. ~ BA5EMENT ~es ~ No SUMP BASKET l'~~ ~0~~ 2 Q 3 ~
WATER IN BASKET t7 Yes SiJMP~~~~ ll0" 0~ 1 ~ 2 Q 3
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN O 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 O Laundty tub a Sanitary sewer ~,,,,,.L7 Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspect'on: ~
When w stern installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement Q Prev' system failed
B. ROOF LEADER5: Y~No DISCHARGE: O Near AC3'' wa
Y
C. YARD DRAIN5 ~ Yes No WINDOW WELLS ~ Yes L9''No
BEAVER SYSTEM ~ Yes o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall O Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
Q Spring ~ Winter
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~ Back 0 Side
SUMP PUMP SYSTEM: L'4~'ASS ~ FAIL You have 30 days to bring your system into eompliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an ap era.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be d~e-tl~ clear ~er d~arges to the storm sewer system.
Inspector: • /"`~'`"`" Date: ,..~ - G -
Resident: ~. ~ ~ ~n 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