HomeMy WebLinkAboutSump Pump InspectionrJ ~ F PR1o
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~~~-,-
Name: C.i ~~ /~~/4~ ~,~~ ~~C~i~~~.~- Date ~ i~ ~~ Time~~~~ m. /p. m.
~o~"' ~~ J~~/~ // ~First In~spe~c ' n QA~'" Second I~
Address: `~ ~1 /% ~~,~ ~! '" Own: I~ Rent. Age of Home:~~
// ~ , Residential: ~ ~
Prior Lake, MN 55 ~~ i~ Phone~~` ~-~ Non-Residential: ~
. ..~~. ~.. `..t.. . `
A. BASEMENT es~ SiJMP BASKE O 0 ~ Q 3 O
WATER IN BA5KET es ~ No SiTMP P ~ 0 ~ 2 ~ 3
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN O 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 utside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection: Q
When was systern installed, or most recently modified? (Date) ~T" /~ why
~ieGS ~'~2 ~/A?O ~
~ Home came with system ~ Response to inspection program ther /VjAi~TE~1 A~~
O Water in basement ~ Prev' s system failed
B. ROOF LEADERS: es No DISCHARGE: ~ Near Gl,•~Kway
0~~ ! ~ ~'"
C. YARD DRAINS p~~ A es ~ N WINDOW WELLS O Yes f~l.~~
BEAVER SYSTEI~ ~"lL~y"~17 Yes o
D. PROPERTIES WITH~UMP PUMPS
When does pump run? ~ Fall er prin~g a Winter
(check all that apply) How often does pump run? ~~N ~/~'~~o ~
V~here does pump discharge to outside? ~ Front ~ Back
NOTES:
SUMP PUMP SYSTEM: i~'"PASS Q FAIL You have 30 days to bring your system into compliance with curr
regulations. When you are ready}'or reinspection, call 657/644-1469 for an ointment.
Is there another place here clear water enters the sanitary sewer system? Ca Yes No
Where is this locatio ?
This area will need o~ xed lear ate ' charges to the storm sewer system.
Inspector: Date:
Resident: Date: -
Disclaimer: This visual inspec 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