HomeMy WebLinkAboutSump Pump Inspection~~ ~~ PR1p
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Name:/ ,~D~i~,ES'S ~~.~./4 ~O ~"'4c~~t/~?~ Da e: ~%~~"~~ Time,~~~~m./p.m.
Address:~'y ~~f~ ~~'UD.r?u ~'~ /~(l~~C=~
Prior Lake, MN 55 ~~,~/ Phone: '~
First Inspe ' n ~cond ~
Own: Rent: ~ Age of Home: 0
Residential: ~
Non-Residential: ~
A. BASEMENT ~ Yes I~~o~ ~/''~ SiJMP BASKET #~~ 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~iQo SUMP P~ Q'"0 Q 1 ~ 2_~ ~ ~3~
WATER IN BASEMENT (flow over floor) 17 Yes I~YNo CISTERN ~ Yes @~3'~0
(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
at Inspection:
a Laundry tub ~ Sanitary sewer O Outside
~ 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 ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: 1~ Yes CA''No DISCHARGE: O Near a Away
C. YARD DRAINS Q Yes C-~'~' N9~''~ WINDOW WELLS ~ Yes ~~3do
BEAVER SYSTEM ~ Yes C~NO
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? "'''
V~here does pump discharge to outside? la Front ~ Back ~ Side
NOTES:
,~'.,~1 P7' o T"~
SUMP PUMP SYSTEM: I~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulatio-u. When you are ready for reinspectian, ca[l 651 /644-4469 }'or an appo ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C~~Vo
Where is this location?
This area will need to be ed~ clear ~r ' c ges to the storm sewer system.
I Inspector: /~"'" Date: ~G ;•G.3 - y 7 I
Resident: 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