HomeMy WebLinkAboutSump Pump Inspection
City of Prior Lake
Sump Pump and III Reduction
Inspection Formi
7f;un1 VOJr sl-/ M4y- k
Prior Lake, MN 55312..
Phone: 'Iq7-Zb~Q
Date: 3- ~- qC} Time:5: /5 a.m.@
First Inspection ~econd 0
Own: ~Rent: 0 Age of Home:/Q5/
Residential: ~ -
Non-Residential: 0
Name:
Address:
117093
No,-/-J /;./.) d ~
A.
BASEMENT ~s 0 No
WATER IN BASKET 0 Yes i2l-'NO
WATER IN BASEMENT (flow over floor)
SUMPBASKET ~/O 1 0 2 0 3 0
SUMP PU)IP l!t"O 0 1 0 2 O,.J 0
o Yes ~o CISTERN 0 Yes ~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
at Inspection:
o Laundry tub
LJ Floor drain.
d Sanitary sewer
o Other
o Outside
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
o Home came with system
o Water in basement
o Response to inspection program 0 Other
o Previous system failed
o Yes ~ DISCHARGE: 0 Near ~y
~~ No WINDOW WELLS 0 YeseJ"'No
~s 0 No
B.
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
C.
D.
PROPERTIES WITH SUMP PUMPS
When does pump run? 0 Fall 0 Summer 0 Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? 0 Front 0 Back
o Winter
o Side
NOTES:
SUMP PUMP SYSTEM: ~ ASS 0 FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 6511644.1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? 0 Yes ~o
Where is this location?
This area will need to be lxed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date:
Date:
3- .y- CJ9
S -f-J- 3J '7
Disclaimer: This visual inspection is done with due diligence to {"md obvious clear water cross-connections
and does not im I the structure meets all Cit Codes.
White: Homeowner
Yellow: City
Pink: HRG