HomeMy WebLinkAboutSump Pump Inspectionr~
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: h~ l 7~~i~,.~" ~ /0' ~C> %,~.~,~
Address: ~~~ ,~~ ~ ~~~ ~~
Prior I,ake, M~1 55~.?/~ Phone~'~`~ "~~6~
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Dat~%G`~ ~~ Time~~~.m./p.m.
First Insp ° n C~' Second ~
Own: Re`n~t: Age of Home:~~~
Re. sidential: @' --j
Non-Residential: ~
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A. BASEMENT es ~ No ,%' SIJMP BASKET ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes I~o 5UMP ~P~~~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes QNo CISTERN ~ Yes ~o
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover wi~l
break seal. Skip to Part B of this form.)
Discharge Point I~ Laundry tub ~ Sanitary sewer O Outside
at Inspection: Q Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
Q Water in basement ~ Previous system failed
B. ROOF LEADERS: I~'Yes ~ No DISCHARGE: ~ Near way
C. YARD DRAINS Q Yes L.~_~_N~ WINDOW WELi,S ~ Yes L~1Vo
BEAVER SYSTEM ~ Yes CYNo
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? '"'~~
Where does pump discharge to outside? Q Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: t~yl'ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca11651/644-1469 for an ' ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be f d s clear w~er Qi~c7~arges to the storm sewer system.
Inspector: ~ ~:/~~L`~' ~"`~" "'-' Date: ~ :~G~ '
Resident: -,.~.- T , -~-> 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