HomeMy WebLinkAboutSump Pump Inspectionc
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City of Prior Lake
Sump Pump and I/I Reduction
Inst~ection Form
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Name: ~it.~~,~OGV /~~~9,~' l..~ Date~'~-~~ Tim~~~Oa.m./p.m.
,~~ ~~ First In~sp~e on LL~Y Second ~
Address:~c~~~~ /~~~d~~ ~ Own: LT~' Rent: Age of Home: ~~
~y~Jl ,/~/ Residential: ~ ~
Prior La~Ce, MN 55 ~/N Phon~'Y~ -~~~~ Non-Residential: ~
/t.~'~l/ c..~i .,.
A. BASEMENT es~ SiJMP BA5KET ~ 0 ~ 2 O 3 ~
WATER IN BA5KET es ~ No SLJMP~~~~ ~ 0 1~ 2 ~ 3~7
WATER IN BASEMENT (flow over floor) ~ Yes o CI5TERN ~ Yes I~~Pd'~^
{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 ~ Sanitary sewer 1~6utside
at Inspection: O Floor drain ~ Other
Prior to Inspection: ~~- ~ ~ ~
When was system installed, or most recently modified? (Date) ~ and why
~ Home came with system ~ Response to inspection program ~er /U ~~ f u rn l-'
~ Water in basement 17 Previous syste failed
B. ROOF LEADERS: I~ Yes ~o DISCHARGE: O Near ~ Away
C. YARD DRAINS ~ Yes L~' WINDOW WELLS ~ Yes ~No
BEAVER SYSTEM ~ Yes C!'~
D. PROPERTIES WITH SUMP PUMPS ~/~
When does pump run? ~ Fall I~Summer prin a Winter
(check all that apply) How often does pump run? F 7G ~'~~ A~ - i h.~
Where does pump discharge to outside? O Front ack
NOTES:
SUMP PUMP 5YSTEM: t9''PASS ^ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[l 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~t,o~ ix~ the clea~ate~ischarges to the storm sewer system.
Inspector:
Resident~
Date: ~
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