HomeMy WebLinkAboutSump Pump Inspection~ 4~ PRIo~
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Name:
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~~-
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~~i~~~ ~~{J~i~a~~ ~.~i' Date~'~~"~ Time j~~~m. /p.m.
/~~~ -~ ~ First In~~s~p~e '~' n ~'" Second ~ 2 ~
Address: ~~o~~ '/~ L~ ~~ • Own: Q" Rent: ~ e of Home.
g ~
' `/,/,y esidential:
Prior Lake, MN SS~cJ~ Phone:7"7 /''~~'~Non-ResidentiaL• ~
A. BA5EMENT ~'Yes ~ No~ SiJMPBASKET 1~ 2 ~ 3
WATER IN BASKET ~ Yes o SUMP~~U~~ 0~ 1 ~ 2 ~ ~
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes o
(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 sewer ~I] Outside
at Inspection: ~ Floor drain ~ Other '''"r
Prior to Inspection: ,,,~-
When was system installed, or most recently modified? (Date) and why
L7 Home came with system ~ Response to inspection program ~ Other
O Water in basement ~ Prev' system failed
n'~~ A ~ ~ /~
B. ROOF LEADERS: 1~ Yes ~ No DISCHARGE: ~ Near @~"wa .
C. YARD DRAINS ~ Yes ~ N WINDOW WELLS es ~'NO
BEAVER SY5TEM ~ Yes o
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? Q Fall O Summer a S~ pr ng Q Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? 17 Front ` O B~ck ~ Side
NOTES: f~'~~4SE ~/rc/ ,~ASEM e'Uy~~ 2~'p ~ h~AS T Tg c, ~~3SrJ. ,~ o x ES .
5'T~C F~ Ev E,2 y cv ~}
SUMP PUMP SYSTEM: v~ASS ~ FAIL You have 30 days to bring your system into compliance wuh current
, regutations. When you are ready for reinspection, ca[I 657 /644-1469 for an nt.
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 s~e clear ~yett~ischarges to the storm sewer system. ,~.-
Inspector: ~-'~ ~
Resident: , ,i2 ~t--~~"
Date: -.~ ~ -
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 '