HomeMy WebLinkAboutSump Pump Inspection~~ ~F PRIp~P
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Name: ~j~~/ ~ L ~'G'L~~~ Date:/ ~~ ~ Time:~~d~a.m./p.m.
-.-~ First Ins ction ~ Second ~
Address: ~~9 ~ ~~/9~/~,~ /~.O ~ ~ - Own: ~ Rent: Age of Home: ~~ k
/ ,~ Residential: ~ ~
Prior Lake, MN 55~i~/ Phone: 'Y~ ~'?~ Non-Residential: ~
A. ~ BASEMENT I~es ~ No_~~ SUMP BASKET I~~ /0~1 ~ 2 O 3 O
WATER IN BASKET I~ Yes l~'No SiJMP P~ @'0 ~ 1 ~ 2 ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~~'No CISTERN D Yes l~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 Q Sanitary sewer ~] Outside
at Inspection: Q Floor drain ~ Other --,.
Prior to Inspection: ~---
When wa~ system installed, or most recently modified? (Date) and why
LL~YHame came with system ~ Response to inspection program ~ Other
Q Water in basement ~ Previous system failed
B. ROOF LEADERS: QY'Yes D No DI5CHARGE: Q Near I°~ Away
C. YARD DRAIN5 Q Yes D_ N~9~' WINDOW WELLS ~ YeslC7~IQo
BEAVER 5YSTEM ~ Yes ~'No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
Q ~,ing ~ Winter
~ $ack Q Side
NOTES;
SUMP PUMP SYSTEM: ~ S ~ FAIL You have 30 days to bring your system into compliance with current
regutations. When you are ready jor reinspection, ca[l 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~.-~do
Where is this location?
This area will need to be f s~clear w~ ~ges to the storm sewer system.
Inspector: /~ ~ "" ~`-"' Date: /~~ ~' 7 7
Resident: (~ ., , ~ --~ Date: ~
Disclaimer: This visu~l inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG