HomeMy WebLinkAboutSump Pump Inspection~ ~ ~~ PR~p
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
l~~~ 7"
Name: ~/`~~~d~il./ ~~i~.E~ic,r~ ~
~~
Address: / ~~~0~ ~~~~~//~~ ~/~
Prior Lake, MN 55~..~~~ Phone:7`'Y ~'~`~~~
Date:~%~-~~ ime/~3~m./p.m.
First Inspe ' ~ Second ~ /2
Own: Rent: ~ Age of Home./J i
Residential: ~ ~
Non-Residential: ~
~t,,, v~.v~ ~, ~, ~
A. BASEMENT es ~ No~ SiJMP BASKET ~ 0 O 2 ~ 3 ~
WATER IN BASKET O Yes o SUMP~~~-~ P~ 0~ 1 ~ 2 17 3
WATER IN BASEMENT (flow over floor) a Yes fo CI5TERN ~ 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 sew~..,, ~ Outside
at Inspection: a Floor drain ~ Other
Prior to Insp tion:
When ystem installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement Q Previous syste ailed
B. ROOF LEADERS: ~ Yes o DI5CHARGE: ~ Near O Away
C. YARD DRAINS ~ Yes L~~!~'~N '''~ WINDOW WELLS ~ Yes o
BEAVER SYS1'EM ~ Yes l~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ S~'ing ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? L~ Front O~tck ~ Side
NOTES:
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SUMP PUMP SYSTEM: I~ASS 17 FAIL You have 30 days ta bring your system into complionce with current
regu[ations. When you are ready for reinspection, ca11651 /644-1469 for an appo' .
Is there another place where clear water enters the sanitary sewer system? Q Yes o
Where is this location?
This area will need to be d s clear wa~ di~ges to the storm sewer system.
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Inspector: , u'~'`~ Date: ~ %c ~ ' 7y
Resident: Date: '
Disclaimer: This visual inspe i n is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG