HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
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`~ `~ Sum Pum and I/I Reduction
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Inspection Form ,Q,~,~)~
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Name:~~C/~~J~~~ ~~~~~~~ Dat~%~~"~~Time,z'~0o a.m./p.m
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(~ First Inspec ~nd Q
Address: ~~~~ ~EitJ~ U'7'~ ~. (,C~. Own: Rent: Age of Home:~2.
~ '/~ r Residential: ~ ~
Prior Lake, MN 55 ~~,~ Phone~~`~~~8~ Non-Residential: Q
A. BASEMENT GlY~es ~ No~ SUMP BASKET ~U~ 1 O 2 ~ 3 ~
WATER IN BA5KET ~ Yes o SUMP ~P~ ~''~ O 1 ~ 2~ Q~' ~
WA1`ER IN BASEMENT (flow over floor) ~ Yes P~~No CISTERN O 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 ; ~ Sanitary sewe,r~ 17 Outside
at Inspection: Q Floor drain d Other
Prior to Inspection: --""
When was systern installed, or most recently modified? (Date) and why
~ Home came with system Q Response inspection program [7 Other
Q Water in basement O Prev' system failed
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B. ROOF LEADERS: Q,~~~ es ~ No DISCHARGE: O Near way
C. YARD DRAINS ~ Yes L~~~N ~ WIlVDOW WELL5 ~ Yes ~o /
BEAVER SYSTEM ~ Yes L4~No
D. PROPER'1'IES WITH SUMP PUMPS
When does pump run? O Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? '''~
WThere does pump discharge to outside? ~ Front Q Back ~ Side
NOTES: / _ - _ __
SUMP PUMP SYSTEM: [~P''~SS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready far reinspection, ca11651/644-1469 for pointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes No
Where is this location?
This area will need to be d~,se~Ie clear w~r~charges to the storm sewer system.
Inspector:
Resident:
Date: .G'
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