HomeMy WebLinkAboutSump Pump Inspection' ~~1 dF PRtp
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection~Form ~a~ ~-
Name~.~v(~~~~~~.~ .~/C`~~i~~6'~... Date~:~~'g,~ Time~Oa.m./p.m.
~, / ~7 ,~ First In~s~pe~c,t3'~~ ~''"Second ~
Address:~~G~ ~~o !v/~,C.E~S'hO.E ~°t~/ s,~ Own: [D~"Rent: C~ Age of Home:~~ ,!
~, f ~'/ ~y Residential: L~'~ ~
Prior Lake, MN 55 ~~~ Phone':~i~'Y /'•~~ Non-Residential: a
~ v cc~~ /c.~ ~.,.
A. BASEMENT es ~ No~ SiJMP BASKET ~~ 1~ 2 O 3 ~
WATER IN BASKET l7 Yes o SUMP P U I~ 0~ 1 Q 2 ~~"
WATER IN BA5EMENT (flow`over flo~r) ~ Yes i~o CISTERN a Yes L~ 1 Qo
(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 a Laundry tub ~ Sanitary sewe~ Q Outside
at Inspection: a Floor drain ~ Other
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Prior to Inspection:
When was system installed, or most recently modified? (Date) and why ~
~ Home came with system ~ Response to inspection program C] Other
Q Water in basemen~ ~~ Pre ' us system failed
B. ROOF LEADERS: ~~ ~ Yes ~ No DISCHARGE: ~ Near way
C. YARD DRAINS ~ Yes I~~~N WINDOW WELi.S ~ Yes l~1Qo
BEAVER SYSTEM ~ Yes l~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? 17 Fall ~ Summer ~ Spring Q Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? 7 Front ~ Back ~ Side
NOTES: ~
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into comp[iance with current
regu[ations. When you are ready for reinspection, call 651/644-1469 for an ap ' ent.
Is there another place where clear water enters the sanitary sewer system? Q Yes o
Where is this location?
This area will need to b~f'ixe~,ao the clea~ater,discharges to the storm sewer system.
Inspector;
Date:
Date:
/. - A~ ~'f ~ J"9 ~
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG