HomeMy WebLinkAboutSump Pump Inspection~Q
0~
~,
~1
~ Name:
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
.~iC/'~-~•~ ~LcI~~~C Date: ~~"~/ Tim~~i'~~f.m./p.m.
~ .~ r r
~
//~~~ ~~~~1~~~ ~~,. First Inspect3on ~-~-'S~eg ond ~ ~ Q
Address:f(C"~ Own: dJ~~''fZent: Q A e of Home: ~LJ'
~ ~ ~, /~/~n~~ Residential: t7---~""~ ~
Prior Lake, MN 55 ~~ Phone• ~y ~~U Non-Residential: ~
A. BASEMENT I~'Yes ~ No SiTMP BASKET ~~~'U~ 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o SLTMP P~~ Q.6' t7 1~ 2~~~ ~3 ~
WATER IN BASEMENT (flow over floor) ~ Yes L~F-iQo CISTERN ~ Yes A'No
:(~f 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 Q Laundry tub O Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other ------
Prior to Inspection:
When was systern installed, or most recently modified? (Date) `J and why
~ Home came with system ~ Response to inspecti on program ~ Other
~ Water in basement ~ C1 Previous system failed
B. R O O F L E A D E R S~ ~ t-~ e s ~ N o D I S C H A R G E: ~ N e a r
~N ~ WINDOW WELi.S ~
C. YARD DRAINS ~ ~ Yes ~
a y
Yes L~No _
BEAVER SYSTEM _~
~ Yes 9' No
D. PROPERTIE5 WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ S ri ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? Q Front ~ Back Q Side
NOTES-•-•-•---•---•---•- -•-•---._._._._._._._._._._.---•-•---•---•---• ~-•-•-•---•-•-•-------•-----•---•-------•-•-•-•---•-•-
i
SUMP PUMP SYSTEM: L3~ASS L'~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready,r"or reinspection, ca!! 651/644-1469 for an a ointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~No
Where is this location?
This area will need to fi so the cle w~t 1r discharges to the storm sewer system. ,
Inspector: ~~ `~-----~ Date: '"~' ' ~'
Resident. „ ~ . ~ _,_ .,.,,.;~ _ _ _,.-- Date: ~~-
Disclaimer: This vlsual inspection is done with due diligence to find obvious clear water cross-connections
and does not unnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG