HomeMy WebLinkAboutSump Pump Inspection~ ~J aF PRIpfA
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City of Prior Lake
Sump Pump and IiI Reduction
Insnection Form
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Name: ~~~i'~S~ ~ 5~~~'.E"LU
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Address:~~~ ~~~~.G.9.~,0 V/~W ~,['
Prior Lake, MN 55 ~~i~ Phone:'~'~'~i~~ ~~~
Date:~"~~'9~ Time:~~~~a.m./p.m.
First Insp tion ~" Second ~
Own: Rent: Age of Home:~ ~
Residential: ~ ~
Non-Residential: ~1
.--..---•~-- • ~~
A. BASEMENT Yes a No ~ SiJMP BAS ~ 0 ~~ 2 I~ 3 17
WATER IN BASKET ~ Yes o SUMP P P Ci 0 1 Q 2_ ~~ O
WATER IN BASEMENT (flow over floor) Q Yes o CISTERN Q Yes ~IQo
(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
at Inspection:
~ Laundry tub ~ Sanitary sewer C~'Outside
~ Floor drain ~ Other
Prior to Inspection: " /
When was system installed, or most re tly modified? (Date) !~ ~~~ and why
~ Home came with system espon to inspection program ~ Other
~ Water in basement ~ Pre ' us system failed
B. ROOF LEADERS: Yes ~ No DISCHARGE: O Near L~~ :
Y
C. YARD DRAINS a Yes WINDOW WELLS U Yes P~ No
BEAVER SYSTEM ~ Yes ~~~
D. PROPERTIES WITH SUMP PUMP5
When does pump run? Q Fall ~ Summer ring Q Winter ~~/~~ y
(check ail that apply) How often does pump run? ~~~ ~ c L"~ '- ~A/ ~~~JE ^~ T
V~here does pump discharge to outside? ~ Front ~ Back Q Side
NOTES:
SUMP PUMP SYSTEM: IZJ''PASS ~ FAIL You have 30 days ta bring your system into compliance with cur ent
regutadons. When you are ready for reinspection, call 651 /644-1469 for an ointmera.
Is there another place where clear water enters the sanitary sewer system? C7 Yes No
Where is this location?
This area will need to b ed the clear ate charges to the storm sewer system.
/'~ _ ~_~ _
Inspector: , ~'" Date: ti'~-~ - 7 y
Resident: , - Date: - /3 -
Disclaimer: This visual .inspection is done with due diligence to find obvious clear water cross-connections
,~ -" and does not unply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG