HomeMy WebLinkAboutSump Pump Inspection~
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City of Prior Lake
Sump Pump and I/I Reduction
~~~~~~~~ Inspection Form ,:~~,~ ~~
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Address: (pQ~~ /l/G~iE'/f~G~ 4G~ ~Q ~ Own: I~' Rent: ~. Age of Home~ ~
~y ,~/~/ '/ Residential: L~''~~ ~
Prior Lake, MN 55 ~/~ Phone"~'y~''~`~~"a Non-Residential: ~
A. ' BASEMENT ~s a No~~ SiTMP BASKET C~/ f~ 1~ 2 ~ 3 CI
WATER IN BA5KET ~ Yes L~J'No 5UMP _P~ ~0 ~ 1 ~ 2 ~ 3 a
WATER IN BASEMENT (flow over floor) ~ Yes Q' N o CISTERN O Yes ~~ 4 0~
(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 inspection program ~ Other
~ Water in basement I~ Previo system failed
B. ROOF LEADERS: ~No DI5CHARGE: ~ Near C~''Away
C. YARD DRAINS ~ Yes [~'N~,9' WINDOW WELLS ~ Yes L~'"No
BEAVER SYSTEM ~ L7 Yes ~VNo
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? --"'
V~here does pump discharge to outside? ~ Front ~ Back O Side
NOTES:
SUMP PUMP SYSTEM: ~''PASS O FAIL You have 30 days to 6ring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an intment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~No
Where is this location?
This area will need to be d~he clear t~charges to the storm sewer system.
Inspector: . ~r~
Resident: ~ ~
Date:
Date:
. .r. ~ -
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