HomeMy WebLinkAboutSump Pump Inspection~F PRIp~
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(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.)
Name: ~~iQ ~ -~L E,,,~ ~+ !I'J .C= ~-
City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
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Date:~/`~9 Time;~/~~m./p.m.
~~~ ~-~''~~~~',,, ~~,,~~„ First Inspe ° n L~9~" Second ~ `
Address: ~ ~r~~~ Own: Re`-nt: ~~ ge of Home:~
~/L/ Residential: CY" ,
Prior L,ake, MN 55~~~ Phone7`7~'-~~~ Non-Residential: ~
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A. BASEMENT es ~ 5UMP BASKET CI 1~ 2 ~ 3 ~
WATER IN BASKET es ~ No 5iJMP P~ 0~ 1 ~ 2~ ~~ O
WATER IN BA5EMENT (flow over floor) ~ Yes L~~'No CISTERN ~ Yes t~'fto
Discharge Point
at Inspection:
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C.
D.
~ Laundry tub ~ Sanitary sewer ~ Outside
~ Floor drain ~ Other
When as system installed, or most recently modified? (Date) ~" and why
Prior to pection:
Home came with system ~ Response to inspection program ~ Other
Q Water in basement ~ Previous system failed
~Af~~ A~
ROOF LEADER5: ~ ~~~,r ~[9' Ye No DISCHARGE: ~ Near Away
YARD DRAINS ~~~~ ~'~~°•~ es ~~ WINDOW WELLS Q Yes A~No
BEAVER SYSTEM ' 1~~' ~ Yes C~'No
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PROPERTIES WITH SUMP PUMPS
When does pump run? Q Fall ~ Summer ~ Spring
(check all that apply) How often does pump run? '''~
V~here does pump discharge to outside? ~ Front ~ Back
NOTES:
SUMP PUMP SYSTEM: C'1'PASS ~ FAIL You have 30 days to bring your sysrem into compliance with current
regulations. When you are ready for reinspection, ca11651 /644-1469 for an appoi ..
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be ed~,a-~R'e clear~~s~harges to the storm sewer system.
Inspector: • ~ ~'' Date: "7' - ~ ~ ~ /
Resident: J ~ ~c• Date:
Disclaimer: Th~Ys visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all City Codes.
~ Winter
~ Side
White: Homeowner Yellow: City Pink: HRG