HomeMy WebLinkAboutSump Pump Inspection~ '~ aF PR.ro
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City of Prior Lake
Sump Pump and I/I Reduction
ction Form ~P,~ ~~
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Name • .~ ~ ~~~ ~~ Dat~~~ ~ ~ Tim m. /p. m.
, ~ ~-~--
--~~y ._-~',. ~~~~ /~~ First Insp~e ' ~'' Second L7
Address:~~ /~~.~J~~~N~ V/,C; u/ /~,p Own: L~~' Rent: Age of Home: ~
`/~/ Residential: ~
Prior Lake, MN 55 ~~%~/ Phpne'?'`'Y~'~~j 0 Non-Residential: ~
A. ~~ BASEMENT ~s ~ No~ SiJMP BASKE ~ 0 ~~ ~ 3 ~
WATER IN BASKET ~ Yes o SUMP P O 0 1~1~ ~ 2 O~,~
WATER IN BA5EMENT (flow over floor) ~ Yes o CISTERN a Yes ~'1Qo
(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 Q Sanitary sewer tside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most rec modified? (Date) /~~ ~ and why
Q Home came with system esponse to inspection program ~ Other
~ Water in basement ~ Pre ' s system failed
B. ROOF LEADER G~ Yes o DISCHARGE: ~ Near way
~~ ~ ~~ Ye a N WINDOW WELLS Q Yes o
C. YARD DRAINS ~ D~` s ~ ~~ ~'iV
BEAVER SYSTEM ( ~ ~ Yes I~VNo
~A~~C~µ 7
D. PROPERTIES WI SUMP PUMPS
When does pump run? ~ Fall Q Summer pring ~ Winter
(check all that apply) How often does pump run? /~~V C~'---~
V~here does pump discharge to outside? I~ Front ack ~ Side
NOTES:
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SUMP PUMP SYSTEM: QVgASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651l644-1469 for an appointm
Is there another place where clear water enters the sanitary sewer system? Q Yes t9-"IQ~o
Where is this location?
This area will need to be ed~Yie clear w~r ~charges to the storm sewer system.
I Inspector: , ~""'""~ Date: .G ~~ ~' 7 7 I
Resident: 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