HomeMy WebLinkAboutSump Pump InspectionQF PRI p~
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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
Name : ~ ~~~~,~' ~~ ~ ,~ , "~~ , ; /-~ .~ "~ /-~,~ / ~ ~,
Address: / z~/~/~ f~~<H; ~l ~,~, T~D aUF
Prior Lake, MN 55 ~' 7.y1 Phone:
Date: ~'-iG ~%~ Time: l~~a ~ a.mJp.m.
First Inspection IT~
Own: L~'~ Rent: Q
Residential: C3'`
Non-Residential: ~
Second ~
Age of Home:~
r.
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A. BASEMENT t3'~Yes ~ No~/ SUMP BASKET a 0 L~1 a 2 ~ 3 l7
WATER IN BASKET I~ Yes I~'No SiJMP PUMP 19~0 Q 1 ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~Io CISTERN O Yes A'1~io
(If no pump, place sticker across edge of sump cover and basement floor so any remaval of cover will
break seal. Skip to Part B of this form.)
Discharge Point ~ Laundry tub ~ Sanitary sewer la Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
D Home came with system C~ Response to inspection program ~ Other
D Water in basement D Previous system failed
B. ROOF LEADERS: 13 Yes I~ No DISCHARGE: O Near L~Away
C. YARD DRAINS ~ Yes C3' No WINDOW WELLS Q Yes Q' No
BEAVER SYSTEM ~ Yes l~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer la Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? t7 Front G Back ~ Side
NOTES:
SUMP PUMP SYSTEM: C~PASS Q FAIL You have 30 days ta bring your system into compliance with current
regulations. When you are ready for reinspection, call 651/64~1-7469 for an pointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes Q~No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector• _~~/ ~ !'1~''~~X,~ ~ Date: G/- /6 - `~ y
Resident ~',~, ~/ ~ , ,,= ~ ~ ~~ , --;"~ Date: ~/ - /b - ~
Disclaimer: This visual spection 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