HomeMy WebLinkAboutSump Pump Inspection~~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~~,~~-r'
~ ~c.~ ,t1~%~ ~, ,a~~. a'~~ ~,/~ Date:~ ~!'/ eJ~~~~
~~ Name: ~ Tim a.m./p.m.
~~J !7 ~~irst Inspect' Second ~ -~
Address : ~ /~~ f / "/ ~i ~~ % Ol.~ ,/f ~,l~ Own: Rent: Q e of Home ~~ S ~
~ y, ~/~/~., ~-~Residential: ~
Prior ~.ake, MN 55 ~/~ Phon~!"7'G' ~~~t~ Non-Residential: a
. •~ -
A. BASEMENT es a No ~ SIIMP BASKET ~ 1 ~ 2 CI 3 C]
WATER IN BASKET l7 Yes No SLTMP P 0 a 1 ~ 2~_~ ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ CISTERN Q Yes ~ No
(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
at Inspection:
O Laundry tub O Sanitary sewe~ a Outside
~ Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modi~ed? (Date)
Q Home came with system
Q Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
and why
~ Response to inspec ion program a Other
~ Previous sys ailed ~
~ Yes No DISCI~RGE: ~ Near ~] Away
i /
a Yes ~ ~ WINDdW WELi.S ~ Yes`f'J''~No
~ Yes C~No ~
~`°~.
,.
~ S~ D Winter
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? Ca Fall ~ Swnmer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
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NOTES: ~~'`
SUMP PUMP SYSTEM
Is there another place where
Where is this location?
This area will need to be f~
Inspector:
Date• ~ /-
Date: -
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 Yellow: City Pink: HRG
O Back la Side
'!~S$ ~ FAIL You have 30 days to bring your system into compliance with current ,
regulations. When you are ready for reinspection, call 651/644-1469 for an ent.
ater enters the sanitary sewer system? ~ Yes No
to the storm sewer svstem.