HomeMy WebLinkAboutSump Pump InspectionJ
~ ~F PRI p~
~ ~ ~'
~ 4 ~C,
U tr1
City of Prior Lake
Sump Pump and I/I Reduction
Ins~aection Form
~~~a~
Name: : (~~~ /~ ~ ~~.~~/~~-~ Date:~ %~~ "~ Time,~~~a.m./p.m.
/ / ~ ~ ~ / First In~sp~e ion ~Y~econd ~
Address: ~~P ~~ at~ ~~-~ s c.~ 7~ 1~-' ~ Own: 0' Rent: Age of Home: ~~~(
,1~ ~/ ~/ ~ Residential: ~ J
Prior Lake, MN 55 ~ 1 ~~/ Phone: Y' Y ~' ~~~~Non-Residentia l: ~
A. BASEMENT ~es ~ No~_~~ 5iJMP BA5KET ~~ ~~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~'No 5iJMP P ~A' 0~ 1 ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes dL~fo CISTERN ~ Yes ~
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover wili
break seal. Skip to Part B of this form. )
Discharge Point ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain a Other
~..--
'~ Prior to Inspection:
When was system installed, or most recently rnodified? (Date) and why
Q Home came with system Q Response to inspection program ~ Other
O Water in basement ~ Prev'ous system failed
B. ROOF LEADER5: L~'Yes ~ No DISCHARGE: l~ Near way
C. YARD DRAINS ~ Yes L~'N WINDOW WELLS es ~ No
BEAVER SYSTEM O Yes f~/1Go
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall O Summer ~ Sgring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~ASS 17 FAIL You have 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, ca[[ 6S1/644-1469 for an appo' .
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to be fy~d sp.~~e clear w~ter c~iscJiarges to the storm sewer system.
Inspector: ~"'``'' Date: -/G' -
Resident: ~ , , // ,' ~ 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