HomeMy WebLinkAboutSump Pump Inspection~F PRIp~
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
~ Name: /~'`" ~~G C~ ~~•C.~ ~U C~N~
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Address: ~~ ~~~--~~ `~"^"'t~'~/.D V /~~/
Prior L~lce, MN 55 ~~''~1 Phone~~o ~0~ ~
Date:~~~~~~ Timer'~'Y~m./p.m.
First In~spfe ~on I~''"~econd ~
Own: ~ Rent: Age of Home: ~
Residential: ~
Non-Residential: ~
~lr.V(N4/C./ </` ~
A. BASEMENT es ~ o SUMP BASKET ~ 0 ~~ 2~ 3 ~
WATER IN BASKET es ~ No SUMPC~~ ~ 0 1~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes I~Y6
(If no pump, place sticker across edge of sumg cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point ~ Laundry tub L~ Sanitary sewer utside
at Inspection: ~ Floor drain la Other
Prior to Ins ction:
When system installed, or most recently modified? (Date) and why
Home came with system O Response to inspection program Q Other
O Water in basement ~ Previ system failed
B. ROOF LEADERS: es ~ No DISCHARGE: Q Near ~''Away
DRAINS ~ Yes ~! N WINDOW WELLS ~ Yes o
C. YARD ~ ~ ~
BEAVER SYSTEM ~ Yes [9~'No
D. PROPERTIES WITH SUMP PUMP5 ~ / _ ~''~
When does pump run? O Fall L9~'~ummer . I~pring ~ Winter
(check all that apply) How often does~~~~~ T~/~ Ci~ !91
V~here does pump discharge to outside? Front ~ Back Q Sid
NOTES: -•-•-------•-•---•---•-•---•-•-•-•-------•-•-•-f--=---•-•-•-•---•-•-------•-------•-----•-•---•---•-•---•-•-•-•---
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SUMP PUMP SYSTEM: l~i~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 appoi .
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be ed s~,o.x~li'e'clear w~ djact~rges to the storm sewer system.
Inspector:
Resident:
Date: '~i~ - ~,3 -
Date: '`" - ~ ,
Disclaimer: T' visual inspection is done with due diligence to f'ind obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City
Pinlct ~IRG'
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