HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name ~~.~~'~,~./~.~"iC ,K.~/C~ ,~;_',
Address: /~ CJ~ / / ~ ~/ ~ ~~~D
Prior Lake, MN 55a.-3 ~~ Phone":~''7 ~~7~~
Date~"~-~- ~~ Time1~~~a.m./p.m.
First Inspe~n B'''~Second ~
Own: (~ Re`nt:~ ge of Home ~,
Residential: L9'" y
Non-Residential: ~
A. BASEMENT ~~ 5UMP BA5KET ~ 0 ~~ 1 ~~
WATER IN BASKET es Q No SUMP~L~ a 0 ~ 1 a 3
WATER IN BASENI~NT (flow over floor) ~ Yes o CISTERN ~ 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 a Laundry tub ~ Sanitary sewer utside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was s installed, or most recently modified?
(Date) ~ J ~ ` and why
~ me came with system ~ Response to inspection program
Water in basement ~ Prev' s system failed
~
B. ROOF LEADERS: ~'`~ ~ es ~ No DISCHARGE:
~ l ~
L~N
~ Other
~ Near ~''Awa
C. YARD DRAINS ~ Yes~ ~ WINDOW WELLS es ~ No
BEAVER SYSTEM ~ Yes 67fiTo
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Summer Spring ~ Wint~
(check all that apply) How often does pump run? ~~7~~'c N EA~~~,~ ra -
V~here does pump discharge to outside? ~ Front ~ Back ide 'r~~
- •-• ~• •-•-•- -- ..•-•-•-•-------•-•-
NOTES: ~ Gl. J~t ~ --/~-~O ~.°7~h1 ~~l c'3 ~
`,u n~ ~ ,,5 o u 7
1,~ ~'
SUMP PUMP SYSTEM: e'PASS L7 FAIL You have 30 days to bring your system into compliance with curr
regu[ations. When you are ready for reinspection, ca11651 /644-1469 for an ointment.
Is there another place where clear water enters the sanitary sewer system? O Yes No
Where is this locat' ?
This area will ne~ b i ed so the ear atet discharges to'the storm sewer system.
Resident:
Date: .~ ' ~ •
Date: -~.~
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG