HomeMy WebLinkAboutSump Pump Inspectioni ~ ~ 4~ PRIp~
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Insnection Form
Name : ~,d ~C~~~N` .~= / ~...J Uy 1,,~ ,~,,~
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Address: ~~ 9 J~.~~'~' ~/-~~C~P~~J,~ ~,~
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Prior Lake, MN 55~~~' Phone:~~D~a
~ Response to inspection program ~ Other
~ Prev' s~system failed
es C7 No DISCHARGEs ear d Away
O Yes ~ No WINDOW WELLS ~ Yes ~ No
~ Yes ~ No
A. BASEMENT f~''ges Q No~~~~' SUMP BASKET QY6 1(~ 2~ 3 ~,
WATER IN BASKET ~ Yes t7~o SiJMP P 0~ 1 ~ 2~ ~~~~
WATER IN BA5EMENT (flow over floor) ~ Yes ~~~ ISTERN ~ Yes LD-~Qo
(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 O Sanitary sewer D Outside
at Inspection: I] Floor drain Ca Other ------
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~ and why
~ Home came with system
D Water in basement
B. ROOF LEADERS:
C. YARU DRAINS
BEAVER 5YSTEM
D. PROPERTIES WITH SUMP PUMPS
t
When does pump run? I~ Fall ~ Summer d~ O Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? Q Front ~1 Back O Side
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NOTES:
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SUMP PUMP SYSTEM: t~'~PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready jar reinspection, call 651/644-1469 for an ap ' ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?.
This area will need to b ed~the clear w~er c]j~s~harges to the storm sewer system.
Resident:
,~~~ J r
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Date~~~'~~ Time•,~oa.m./p.m.
First Ins ~e n~~ond Q )
Own: ~'' Rent: Q ge of Home:~/~
Residential: ~ ~
Non-Residential: O
Date: ~ ~~ -
Date: ~ ~~
I Disclaimer: Thi,g~vi~ual inspection is done with due dili,~ence to find obvious clear water cross-connections I
and does not i~nlv the structure meets all Citv Codes.
City of Prior Lake
Sump Pump and I/I Reduction
White: Homeowner Yellow: City Pink: HRG