HomeMy WebLinkAboutSump Pump Inspectionr~n
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Name: LC.C..C, .8,~.~' ~'~',~'/i/
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Address: ~ /~~v rL~~'r.~~t" ~~~'
Prior Lake, MN 55 ~~iv Phone~''y` !~'~~g ~
City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Date:~U"~'~.~J~9/ Time~J~a.rn./p.m.
First In~sp~ on ~'' Second ~
Own: I~' Rent: Age of Home:Z g
Residential: ~ ~
Non-Residential: ~
A. BASEMENT es Q No 5UMP BASKET ~_~0 1 L7 2 Q 3 O
WATER IN BASKET 17 Yes o SiJMP P ~'0 ~ 1 L7 2~~ L7
WATER IN BASEMENT (flow over`floor) ~ Yes ~~'~ISTERN ~ Yes I~IQo
(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 O Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other '"'~
Prior to Inspection: "'"
When was systern installed, or most recently modi~ed? (Date) and why
D Home came with system ~ Response to inspection program D Other
a Water in basement ~ Previ system failed
B. ROOF LEADERS: fi~ ~~No DISCHARGE: O Near a
P~ ~~~ ~~/''
C. YARD DRAINS ~ Yes l~_~ N /o ~ WINDOW WELLS I: Q~ e s Q No
BEAVER SYSTEM ~ Yes l~'NO
D. PROPERTIES WITH SUMP PUMPS
When does pump run? D Fall ~ Summer ~ S~ring ~ Winter
(check all that apply) How often does pump run?
Vt~here does pump discharge to outside? I~ Front Q Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~PASS Q FAIL You have 30 days to bring your system into comp[iance with cur ent
regulations. When yow are ready for reinspection, call 651 /644-1469 for an ointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be ed~he cle~a~ischarges to the storm sewer system.
Inspector: ~/~"`"~r """"~ Date: ~
Resident: _~ ,~,x ", `~~-~s _ %',~,~ n. ~~, Date: ~
Disclai~mer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not implv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG