HomeMy WebLinkAboutSump Pump Inspection~~
1~~
~
~~-~~
1 ~~ ~
~
~'
City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
J _..~+
~ ~
Name: ~~~~~~~% ~ /~~ Datf~'~`~~ Time~~~~a.m./p.m.
//~ First Inspe n ~--''Srecond O
Address:~~~'~r~~~~~~~C.•~i~ ~~% Own: Rent: ~C/l' Age of Home:~~
,(/~/.y~ ~/ Residential: Qi' ~
Prior Lake, MN 55 ~~j~ Phone~:7"7 /- °7'f~~ Non-Residential: ~
A. BASEMENT ~s ~ No~~~ SIJMP BASKET 1~ 2 ~ 3 ~
WATER IN BASKET 17 Yes L9~No SiJMP P~ 0 I~ 1~ 2~ ~/~ ~
WATER IN BA5EMENT (flow over floor) ~ Yes L~~'No CISTERN ~ Yes 4~'No
(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 17 Laundry tub O Sanitary sewet~ Q Outside
at Inspection: ~ Floor drain ~ Other
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 ~ Prev' us system failed
B. ROOF LEADERS: ~I'es a No DISCHARGE: ~ Near ~way
C. YARD DRAINS ~ Yes [~ WINDOW WELLS ~ Yes ~lQo
BEAVER SYSTEM ~ Yes ~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? D Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? --
V~here does pump discharge to outside? ~ Front O Back ~ Side
.-•-•-•-•-•-•-•-----•-•-•-•-•-•-•-•-•-•---•-•---•-•-•-•-•-•-----•-•-•-•-•-•-•-•-•-•-•--~"------------------------~-._._.
NOTES:
_,--'
SUMP PUMP SYSTEM: ~"T'ASS ~ FAIL You have 30 days to bring your system into campliance with current
regulations. When you are ready for reinspection, ca[l 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~'"No
Where is this location?
This area will need to be ~ed~e the clearyva~ischarges to the storm sewer system.
Inspector:
Resident:
Date: _~-,GFJ'
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