HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Name: ~~~~ / ~`.'~~/~-/ ~
Address: ~~ ~,3 ~4 OSEI.~~.: L-~ ~ v
Prior Lake, MN 55 ,`~~ 7~ Phone;ZZ~ -~~~ f
Ins~ection Form
Date:~r~'~1r Time:~Qa.m./p.m.
First Inspection a'" Second ~ ,
Own: ~Rent: ~ Age of Home:
Residential: L'~-3•-~
Non-Residential: ~
A. BASEMENT ~ Yes [IY1Qo~ SLJMP BASKET ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o SUMP ~P~ 0~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes L~No CISTERN ~ Yes ~,P~6~~
(If no pump, place sticker across edge of sump cover and basement floar so any removal of cover will
break seal. Skip to Part B of this form. )
Discharge Point ~ Laundry tub ~ Sanitary sewer.,.~ ~ Outside
at Inspection: ~ Floor drain Q Other
...-
Prior to Inspection:
When was system installed, or most recently modified? (Date)
~ Home came with system
D Water in basement
B. ROOF LEADER5:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program ~ Other
~ Previous s failed
and why
O Yes No DI5CHARGE: ~ Near ~ Away
Q Yes ~~N/o WINDOW WELL5 I~ Yes P~"No
~ Yes ~o
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? I~ Fall ~ Summer I~ Spring ~ Winter
(check all that apply) How often does pump run? '
V~here does pump discharge to outside? ~ Front ~ Back O Side
NOTES- --~~~1 Gc.J L •~f'~4 G G;------•-----•-•- - ---•---•- - -•-•-~=~=------------•-•-•-•- -•-•----- - -•-
SUMP PUMP SYSTEM: Q~PASS ~ 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 otntment.
Is there another place where clear water enters the sanitary sewer system? Q Yes ~1 No
Where is this location?
This area will need to b~e e clear wat di~harges to the storm sewer system.
Inspector:
Resident:
Date: ~ -.:f0 -
Date: ~ 30 -
I Disclaimer: This visual inspection i~one with due diligence to find obvious clear water cross-connections I
and does not impl_y the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG