HomeMy WebLinkAboutSump Pump Inspection1~
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
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Name: ~ w~ , ~ r~ ~ ,-,!, /~~
Address: ~~ G~ ~ ~ , , ~ ~1,~ ~..}:: ti ~
Prior Lake, MN 55~~ Phone:
Date: ~- ~f~ - ~~ Time:l~-~r~ a.m./p.m.
First Inspection C~'~Second d
Own: I~Rent: ~ Age of Home: /j
Residential: ~"'
Non-Residential: ~
v~% ' ro G ,
A. BASEMENT es ~ No SiTMP BASKET ~~ 1 ~ 2 ~ 3 O
WATER IN BA5KET L'~ Yes ~ No SUMP PUMP f~'l5 d 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) 0 Yes ~~ CISTERN ~ Yes 13'~fo
D.
(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 O Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: D Floor drain ~ Other
Priar to Inspection;
When was system installed, or most recently modified? (Date)_
and why
~ Home came with system ~ Response to inspection program ~ Other
~1 Water in basement O Previous system failed
B. ROOF LEADERS: L~' Yes ~ No DISCHARGE: L~''l~ear ~ Away
G YARD DRAINS ~ Yes t~Vo WINDOW WELLS O Yes C-f'1~o
BEAVER SYSTEM Q Yes ~''N~`o
NOTES:
Inspector: ~ Date: ' ~ -
Resident: Date: 6 - / - y~
SUMP PUMP SYSTEM: ~ PASS L~ FAIL You have 30 days tn bring your system into comp[iance with current
regulaaons. When you are reddy jor reinspecrion, caU 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes Q"No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
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
PROPERTIES WITH SUMP PUMPS
When does pump run? Q Fall O Summer ~ Spring la Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? O Front ~ Back a Side
Yellow; City
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Pink: HRG