HomeMy WebLinkAboutSump Pump Inspection,~ `..~,..., ~~~~~
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
Name:
/va~°c.~ ~' S i ~l~ ~ ~• YYI J"~t'
Address: /.~.Sv''~/ /~i~-C'/~'G't,c... C,./'~.,
Prior Lake, MN 55 Phone:
Date: r~' •~'''`~ S'S Time: ~
First Inspection ~ Second Q
Own:~, Rent: ~ Age of Home:
Residential: l~,'
Non-Residential: ~
A. BASEMENT ~ Yes ~1o SUMP BASKET ~ 0 O 1 ~ 2 0 3 Q
WATER IN BA5KET Q Yes Q No SUMP PUMP ~ 0 ~ 1 ~ 2 ~ 3 O
WATER IN BASEMENT (flow over floor) ~ Yes 1~Io CISTERN ~ 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 ~ Laundry tub ~ Sanitary sewer Q Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home carne with system ~ Response to inspection program ~ Other
a Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes {~ No DISCHARGE: D Near Q Away
C. YARD DRAINS Q Yes~ No WINDOW WELLS O Yes ~ No
BEAVER 5YSTEM a Yes ~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? Ca Fall Q Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? ~~~. _
V~here does pump discharge to outside? ~ Front ~ Back ~"17 Side
-•-•-•-•-•-•-•-•-•-•-•~•-~ =- •-•- - ---._.-•-•---•-•-•- ~--•-•-•---._._.-•-•---•-•-•-•---•-•-•---._._.~-.-•---•-•-•-•-•-----•-•-•-
SUMP PUMP SYSTEM: ~ PAS5 ~ FAIL You have 30 days to bring your system into compliance with current
~1 reguladons. When you are ready for reinspection, call 651 /644-1469;~ir tin appointment.
Is there another place., where clear water enters the sanitary sewer system? ~ Yes ~No
Where is this location?
This area will~e~i to be~xed sc~ the clear water dj~arges to the storm sewer system.
Inspecto • Date: _~
Resident: 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