HomeMy WebLinkAboutSump Pump Inspection~o ~~
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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
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Name: /~/~,ry ,L-,~ ~ ~-, / ,~ ~'~ ~~~ Date:~~_ ~~~Time~.m./p.m.
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First Inspection econd a
Address: ~ Own: ~nt: Age of Home:
Residential: ~,.~''
Prior Lake, MN SS~y~~ Phone,~/i~~~ f Non-Residential: ~
A. ~A~VIEDQT a No~~N / SUMP BASKET ~~~ 0~P1~.Y~ 2 Q 3 O
WATER IN BAS T O Yes f~~ SUMP PUMP '6 a 1 ~ 2 ~ 3
WATER IN BA5EMENT (flow over floor) ~ Yes ~,I~GISTERN O Yes ~
(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 sewer Q Outside
at Inspection: ~ Floor drain ~ Other _,.,..,--
Prior to Inspec ' .
When was stem installed, or most recently modified? (Date) "" and why
me came with system ~ Response to inspection program ~ Other
Water in basement ~ Previous system fa'led
B. ROOF LEADERS: ~ Yes ~ DISCHARGE: la Near ~ Away ~
C. YARD DRAINS ~ Yes a.~o WINDOW WELLS Q Yes 7f~6~
BEAVER SY5TEM ~ Yes a~~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring Q Winter
(check all that apply) How often does pump run? /'
V~here does gump discharge to outside? ~ Front ~ Back ~ Side
NOTES: -._.- -•-•-• --•-•-•-----•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•-•---•-•-•-•-•-•---•-•- - -•-•-•- ---•---•-•-
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SUMP PUMP SYSTEM: O~ P~rSS ~ FAIL You have 30 days to bring your system into compliance with current
~~ regu[ations. When you are ready for reinspection, ca11 6 5 7 /644-1 46 9 for an appoi .
Is there another place where clear water enters the sanitary sewer system? ~ Yes
Where is this location?
This area will need to be ~ed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: ~ c~ _ ~ c~
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Date: ~ c~ ~ ~o
I Disclaimer: 'P~fis visual inspection is done with due diligence to find obvious clear water cross-connections I
~ and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG