HomeMy WebLinkAboutSump Pump Inspection~ ~F PRIp~P
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Name: `~~~~ ~' ~Q~
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Address: ~~~~~ /~~~ ~~~5 f~ f~
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Prior ~ake, MN 55~ /~ Pho r~~ ~J/~
Date:~"7` 7 Time,rfo~a.m./p.m.
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First In~sp~ect° '" Second ~
Own: C9~ Rent: ~ Age of Home ~~
Residential: ~ ~
Non-Residential: ~
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A. BASEMENT es ~ No~ ~ SUMP BA5KET ~ 1 O 2 ~ 3 ~
WATER IN BASKET ~ Yes D~-P~o SUMP P 0 O 1 ~ 2 ~ 3
WATER IN BASEMENT (flow over floor) ~ Yes ~CI5TERN ~ Yes ~
(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:
a Laundry tub ~ Sanitary sewer ~_ Outside
a Floor drain ~ Other
Prior to Inspection: '~
When was system installed, or most recently modified? (Date) and why
~ Home came with system Q Response inspection program ~ Other
O Water in basement ~ Prev' system failed
B. ROOF LEADERS: es ~ No DISCHARGE: Q Near e'Away
C. YARD DRAINS Q Yes t~7 ~N WINDOW WELLS ~ Yes ~
BEAVER SYSTEM ~ Yes C~''No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
Where does pump discharge to outside? a Front
~ Spring ~ Winter
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~ Back ~ . ~ Side
NOTES: ~
SUMP PUMP SYSTEM: ~ASS ^ FAIL You have 30 days to bring your system into compliance with current
regutarions. When you are ready for reinspection, call 651/644-1469 for an a tntment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C4''No
Where is this location?
This area will need to ixed~se~he clear , ter cj3s~harges to the storm sewer system.
Inspector:
Date: '`~`-
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. __ _
White: Homeowner Yellow: City Pink: HRG
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