HomeMy WebLinkAboutSump Pump Inspection/~
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Name:
City of Prior Lake
Sump Pump and I/I Reduction
ction Form
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Address:~~(~ ~ / ~~~~~~ ~~t1
Prior L e, MN 55~~ Phone-:J ~~"~~~~
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Date: ~ - l~ ~~ Time;~f~~°'a.m./p.m.
First In~s~p~ec ' n ~ Second ~ /
Own: C~'' Re~nt: /~ Age of Home: l
Residential: ~Y" ~
Non-Residential: ~
f„l ,.. - ~ _ - _
A. BASEMENT es ~ SiJMP BA5KET ~ 0 ~2~ 3 ~
WATER IN BASKET es ~ No SLTMP P~~ Q 0 ~~'' 1 O 2 ~ ~3,,~-~
WATER IN BASEMENT (flow over floor) ~ Yes ~~'No CISTERN O Yes 13~fiTo
(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 Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection: ~"~j' ~" C ~
When was system installed, or most rec y modified? (Date) ,~' ~ and why
Q Home came with system esponse to inspection program ~ Other
L7 Water in basement ~(' ~ Pr ous system failed
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B. ROOF LEADERS:/f ~~~ Yes ~ No DISCHARGE: Q Near ~ Away
C. YARD DRAINS ~ a Yes -Q-' ~N WINDOW WELLS ~ Yes @~'No
BEAVER SYSTEM ~ Yes B''NO
D. PROPERTIES WITH SUMP PUMPS L,~
When does pump run? ~ Fall L~'Summer ~ring/~ O Winter
(check all that apply) Hqw often does pump run? f- /~~' I'~-A~r~ ~'c,~.~ r
V~here does pump discharge to outside? ~ Front ~ Back ' e
NOTES:
SUMP PUMP SYSTEM: ~~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appo' ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b ed clear wat dis~rges to the storm sewer system.
Inspecto~ • / `~ Date: "r` -~ /-~ -' 7 /
Resident: ,~ Date: '~~ /.S'
Disclaimer: This visual inspection is done with due ' gence to find obvious clear water cross-connections
and does not imulv the structure meets all Citv Codes.
White: Homeowner Yellow: Ciry Pink: HRG