HomeMy WebLinkAboutSump Pump Inspectiona~ PRro~
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City of Prior Lake
Sump Pump and I/I Reduction
ction Form
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' [ ) Name:
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Date:7''~Q`~ Time:/~~~a.m./p.m.
sn -~ _, ,,- First Inspe ion ~' Second ~ ~
Address: ~t.~ 7~y0~~~~ ~l ~~'~ Own: Re~nt~: " Age of Home: ~
~h~ Residential: L9'" ~
Prior ake, MN 55 ~~~ Phon~iL~o `"~~ ~ Non-Residential: ~
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A. BASEMENT es D No~~~ SUMP BASKET ~ 1~ 2 ~ 3 O
WATER IN BASKET I~ Yes Q"No ~„~,~ SiJMP ~P~ 0 Q 1 ~ 2~~-I~~ ~
WATER IN BASEMENT (flow over flo~r) ~ Yes ~1Qo CISTERN ~ Yes ~'No
(If no pump, place sticker across edge of sump ~over and ;basement floor so any removal of eover will
break seal. Skip to~'art B of this form.)
Discharge Point I~ Laundry ~ ~ Sanitary sewer Q Outside
at Inspection: Q Floor dra' ~ Other '-
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Prior #o Inspection:
When s system installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: f t~~ ID~Yes No DISCHARGE: ~ Near Q' Away
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C. YARD DRAINS ~~~~~,{ es WINDOW WELi.S ~ Yes No
BEAVER SYSTE L~~i ~ 1~ Yes No
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D. PR~PERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Sprin ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? . ~ Front ~ Back-~ ~ Side
NOTES:
SUMP PUMP SYSTEM: PASS I~ FAIL You have 30 days to bring your system into comp[iance wi current
regu[ations. When you are ready,t'or reinspection, ca[[ 651/644-1469 for appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need t e fix o the clea a dj-scharges to the storm sewer system.
Tnspector: - Date: - ~d -
Resident: ,, , T . ~ ~ Date: - ~ a -
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all Citv Codes.
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White: Homeowner Yellow: City Pink: HRG