HomeMy WebLinkAboutSump Pump Inspection,
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City of Prior Lake
Sump Pump and I/I Reduction
Inspectian Form
P~ 7~
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, Date: Tim a.m./p.m.
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,/~ /~ f,~~ First Insp~ on 4~ Second Q
Address: '7~~~ ~" /~~~ ~~ ~~ ~ Own: L~' Rent: A e of Home: ~
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~y ` f~,/~l Residential: LzY
Prior L~ke, MN 55 ~/~ Phone:7` '7`~ ~~-XF ~ Non-Residential: Q
/ ,.. , . ._. ~ ~ .~', _
A. BASEMENT ~ a No~ SiJ1VIP BASKET C~ 0 ~ 2 O 3 Q
WATER IN BASKET ~ Yes o SiJMP P~ 0 Q 1 ~ 2~ ~~~' ~
WATER IN BASEMENT (flow over floor) ~ Yes ~y3Qo CISTERN [7 Yes t9'No
(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.j
Discharge Point ~ Laundry tub ~ Sanitary sewer ~Q~Qut~ide
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When ~system installed, or most recently modified? (Date)_
Home came with system ~ Respons inspection program
~ W t 'n bas ent Q Prev' s stem failed
~ Other
and why
a er i em s y
B. ROOF LEADER : ~~i es No DISCHARGE: ~ Near way
C. /
C. YARD DRAINS ~ ~~ ~ es ~ No WINDOW WELLS Q Ye~s~7'~No
BEAVER SYSTEM ~ 14 ~ ~ ~ Yes ~~
D. PROPERTIESrWI~'H 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
NOTES: :
~ Side
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appo ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~
Where is this location?
This area will need to ixed e clear ~er ~targes to the storxn sewer syst~,rn.
Inspector~-- '~''v`'''"" "" ~ Date: '~Y~~~
Resident: ,~--- . ~ ;-~ ~. Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG