HomeMy WebLinkAboutSump Pump Inspection
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
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Name: ~~ N !~~ 1 DateJ %~'~"~~ Tim~~~Q.m./p.m.
~y /~--,.''~ ~~ First In~sp_e,,c ~° ~ ~'' Second ~
Address: ~~l ~~J' /~~/~~/OrV 7~ /~ ~ Own: C9'" Rent: ~ Age of Home: ~' S
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Prior I~ake, MN 55 ~~i~`~ Phone~Y'y~-'~~~.5 Non-Residential: ~
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A. BASEMENT es ~ I~Tt~ 5iTMP BA5KET Ca 0 1~ 2 ~ 3 ~
WATER IN BASKET ~.T~ es ~ No SUMP P 0~ 1 ~ 2~ ~~~.3--~D
WATER IN BASEMENT (flow over floor) ~ Yes ~~CISTERN ~ Yes ~No
(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: a Floor drain ~ Other ~'"~
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Prior to I pection:
~ When s system installed, or most recently modified? (Date)
Home came with system D Response to inspection program ~ Other
~ Water in basement 17 Previous system ailed
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
and why
~ Yes o DISCHARGE: I~ Near ~ Away
~ Yes WINDOW WELL5 ~ Yes ~
~ Yes No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES: ~
~ Spring ~ Winter
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I~ Back ~ Side
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into comp[iance with current
regulations. When you are ready for reinspection, cal! 651l644-1469 for an ap ent.
Is there another place where clear water enters the sanitary sewer system? Q Yes L~~~~
Where is this location?
This area will need to be ed~se~fie clear t~tfte~charges to the storm sewer system.
Inspector:
Resident:
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Date: ~..~ ~i / ~
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