HomeMy WebLinkAboutSump Pump Inspection~ Ci ;`~- ~
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City of Prior Lake
~~ A.
B.
C.
Sump Pump and I/I Reduction
Inst~ection Form
Name: ~f,:~ , J~' ~,~5 f ,,,~u~l ~
Address: /~~3n p~r~/~ ~/
Prior Lake, MN 55 3 72 Phone: S~S~v- y3b.5
Date: L ~ ~~'~`~`~ Time:i~' 3~a.mJ~
First Inspection L~''~Second ~
Own: L3'" Rent: ~ Age of Home:
Residential: [~
Non-Residential: ~
BASEMENT ~es ~ No / SUMP BASI~ET ~~~0 ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET 17 Yes I~Vo SUMP~_P-~} P ~" 0 Q 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~P~'O CISTERN ~ Yes Q-~o~
(If no gump, 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 O Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: O Floor drain a Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)_
~ Home came with system ~ Response to inspection program
O Water in basement ~ Previous system failed
ROOF LEADERS:
and why
~ Other
Yes ~ No DISCHARGE: Q Near ~ Away
Q Yes ~~'~''r WINDOW WELLS Q Yes ~ No
~ Yes ~" No
D. PROPERTIES WITH SUMP PUMPS
W1ien does pump run? ~ Fall ~ Summer
(eheck all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
Q Spring ~ Winter
C~ Back O Side
SUMP PUMP SYSTEM: ~"~SS ~ FAIL You have 30 days to bring your system into compliance with current
` regulations. When you are ready for reinspection, cal[ 651/644-1469 for an rtppointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~' Date: z- ~~- 9~
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.
YARD DRAIN5
BEAVER SYSTEM
White: Homeowner Yellow: City Pink: HRG