HomeMy WebLinkAboutSump Pump Inspection~0
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
Name: ,~~ Ex~ ~~~ ~ ~(, ,. ~~~... ~ k~~~;
Address: ~~~ `7' ~7 ~~~% ~~~ ~~ Nt~
Prior Lake, MN 55 ?" 7,~ Phone: ~/ y 7- 7 d~ ~
Date: '~f~ ~~~ ` y~ Tirne: /~1 ~ a.m./p.m.
First Inspection Q'
Own: ~ Rent: ~
Residential: ~
Non-Residential: ~
Second ~
Age of Home:~
G. ~~N ~
A. BASEMENT I~Yes ~ No SUMP BASKET I~ 0~ 1 ~ 2 O 3 ~
WATER IN BASKET ~ Yes ~ No SUMP PUMP C-1'~ 0~ 1 ~ 2 Q 3 t]
WATER IN BASEMENT (flow over floor) 17 Yes C~To CISTERN a Yes ~iVo
(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 ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection: .
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspecti on program ~ Other
ta Water in basement ~ Previous system failed
B. ROOF LEADERS: C'J Yes ~ No DI5CHARGE: ~ Near ~'Away
C. YARD DRAINS a Yes l3'No WINDOW WELLS ~Yes ~ No
BEAVER SYSTEM D Yes L~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? l~ Fall Q Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES: - - -a ~ f ~ f~/ ~~ h 7~' ~ li O Lt J~c' - ' ~~'v w- -•--~7 </ /79/'r n ~S, ~-----•-•-•---•---•-•-
~.~`C d c~ v~-. G i t trP ~
SUMP PUMP SYSTEM: PASS a FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready jor reinspection, call 6511644-1469 for an pointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes C~ No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: '~`'~ °•~~` Date: `/- / d- y 9
Resident: ' Date: y- / G- y y
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.
S ~ e Dd/o ~~,5
White: Homeowner Yellow: Gity Pink: HRG