HomeMy WebLinkAboutSump Pump InspectionF`
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
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Name: ,~~ ~ ~~%~~ ~ .~'"1/~/~ Date~'a-Jp`~ Time~~~~a.m./p.m.
/,~/ ~`' ' '~ ~~ irst In_sp ~ion ~cond ~
,
Address:~~~~0' 7....L~~C.I~.A.If /.CL~ Own: IJ' Rent: '" Age of Home: ~(~
r~ ~ Residential: ~
Prior Lake, MN SS~~iu Phone'~"'r'l~'~i~~~ Non-Residential: Q
/ t.r'S/YV v I4~ ~ ~
A. BASEMENT es ~,,ATo SUMP BASKET ~ 0 ~' 1~ 2 ~ 3 ~
WATER IN BASKET tD~~es ~ No SUMP PUMP ~ 0 D~'~~ 2~ ~
WATER IN BASEMENT (flow over floor) ~ Yes ~-~'o CI5TERN ~ Yes o
(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:
~ Water in basement Q Previous syste i ed
B. ROOF LEADER5: ~ Yes o DISCHARGE: ~ Near ~ Away
C. YARD DRAINS ~ Yes I~ N o WINDOW WELLS Q Yes ~.~5~
BEAVER 5YSTEM ~ Yes L~'IQo ~
Prior to Inspection: ~ A~ ~
When was system installed, or most recently modified? (Date) ~ and why
u57' ~~ CA S E
Q Home came with system ~ Response to inspection program Other
D. PROPERTIES WITH SUMP PUMPS ~~
When does um run? ~ Fall C9'Summer rin ` )~ Winter ~ )
(check all that apply) How often does pump run? /~ ~ rL /`~E ~ t~ ~~~J
Where does pump discharge to outside? ~ Front ack Q Si
NOTES:
SUMP PUMP SYSTEM: U PASS ~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready for reinspection, ca[l 651 /644-1469 for an ap era.
Is there another place where clear water enters the sanitary sewer system? ~ Yes NL~T~ o~
Where is this location?
This area will need to be~xe~ the clea~ate~scharges to the storm sewer system.
Inspector:
Resident:
~ Laundry tub ~ Sanitary sewer utside
~ Floor drain ~ Other
Date: ,,,~ - GU-
Date: _~ - Z c~ -
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Ye11ow: City Pink: HRG