HomeMy WebLinkAboutSump Pump InspectionaF P~to~, ~ ~ .
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~~ ~ City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~
Name: q c~ c' ~,r r~ S
Address: '~CJ D U (~ ~ % vL~ !~ (~ ~~'V
~LLQ
~~
Prior Lake, MN 55 3 ~ Phone: ~~( ~'" ~,/~
Date: ~~°~ Time: ~~ ~a.m p.m
First Ins ection~ Second ~ ~/~
Ow„ •.,~ Fe:~ Age of Home: L.V
~`''~
Residential%"~
Non-Residential: ~
A. BASEMENT ~7 Yes ~ No SiJMP BASKET ~, 0~ 1 O 2 ~ 3 ~
WATER IN BASKE o SiJMP PUMP 0 O 1 17 2~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ..~to CISTERN ~ Yes ~-No
(If no pump, place sticker acrass edge of sump cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point Q Laundry tub ~ Sanitary sewer Q Outside
at Inspection: ~ Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
B.
C.
D.
NOTES:
Q Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
ROOF LEADER5: ~ Yes~ No DISCHARGE: ~ Near ~ Away
YARD DRAINS ~ Yes~ No WINDOW WELLS ~Yes ~ No
BEAVER SYSTEM ~ Yes~No
PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall Q Summer ~ Spring
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front Q Back
Ca Winter
~ Side
SUMP PUMP SYSTEM: ~PASS ~ FAIL You have 30 days to bring your system into compliance 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 b~fi~e~T}~i the clear w er discharges to the storm sewer system. ~, „
Resident: v~~r~,, ~ ,.~~ ~;; ,.(1 ~~~--
,
Date:
Date: %;~ - ~:'~-;
Disclaimer: This vis~{ial 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: Ciry Pink: HRG