HomeMy WebLinkAboutSump Pump Inspection!,
/'!~ ~ ~~ PRIp~P
~~~ ~`~c.~ .~ ~
~.) ` U ~
City of Prior Lake
Sump Pump and I/I Reduction
~ Insnection Form
,., . . _
~' ,v,~a ~ic~~ `~
Name: ~ , ,~~~C.~1' Date~~~~ ~'~~Time:(~~.m./p.m.
.
/ /~ /' ,, ~' ~r'~' First In~sp~ec ' n L~"Second ~
Address:~f(J~D/w4.t1,E f,~~% ~G~~C~4~tlD Own: ~'" Rent: ~ e of Home: ~0~ f~
,~/,/ y./ Residential: ~1
Prior Lake, MN 55 ~~r~ Phone:-7`"Y !~"!'~`~~ Non-Residential: a
~r
A. BASEMENT a Yes t~-i~o~~_/ SUMP BASKET A'~ ~ 2 Ca 3 Q
WATER IN BASKET ~ Yes [7YIQo SUMP P ~~ Q 1 a 2~ ~_,3..~'
WATER IN BASEMENT (flow over floor) ~ Yes IZLiUCfo CI5TERN ~ Yes m~o
(If no pump, place sticker across edge of sump cover and basement flvor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point ~ Laundry tub ~ Sanitary sewer la Outside
at Inspection: d Floor drain ~ Other ---~
Prior to Inspection: ~-'"
When was system installed, or most recently modified? (Date) and why
~ Home came with system O Response to inspection program ~ Other
~ Water in basement D Previous system failed
B. ROOF LEADERS: l~'Yes ~ No DISCHARGE: ~ Near ~way
C. YARD DRAINS ~(.Jr~~~ t~Yes Q_ N/o ''~ WINDOW WELLS ~ Yes Ca-~"o
BEAVER SYSTEM Y~ ~ Yes GVNO
D. PROPERTIES WITH SUMP PUMPS
When does pump run? CI Fall ~ Summer ~ Spring Q Winter
(check all that apply) How often does pump run? ~'
V~here does pump discharge to outside? 17 Front ~ Ba~CIc I~ Side
NOTES: ~---•--~G~ ~~ ~^'T ~j(/ ~ 7~E',~ ~~~G<,~ ~~ --- ~ •- - -•-•-----•-•-
.t,/.L~ if'~~7~~'~'~
SUMP PUMP SYSTEM: I~'ASS ~ FAIL You have 30 days ro 6ring your system into compliance with current
regulations. When you are ready for reinspection, ca11651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes (~''No
Where is this location?
This area will need to b ixe _ the clea~ate~charges to the storm sewer system.
Inspector. -/ ~"" ~ ~--~' Date: .~ -~~ ~ ~y _
Resident: ~ , ~ ~ V /~ ~j Date: . •3 T
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not unnlv the structure meets all Citv Codes.
White: Homeowner Yellow: Ci~ Pink: HRG