HomeMy WebLinkAboutSump Pump Inspection/~ ~ ~~`
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~ ~ City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~,~~~;
l'/ `~ ~ / ~/ ... First Inspe tion Second ~
Address:,,/'y~~l~p ~C~'.Eu/44U /~1~ N..~ - Own: ~Rent: ~ Age of Home: 8/~~
~y c~ Residential: ~
Prior Lake, MN 55 Phone:~~/ "~~/~ Non-Residential: ~J
~,OLJ E~= ~C.. ~~!~
A. BASEMENT es ~ No~~~ SUMP BASKET Q 0 C9~ 1 Q 2 ~ 3 ~
WATER TN BASKET l~ Yes f~-No J SUMP PiTM_p ~~ 1 Q 2~ O
WATER IN BASEMENT (flow over floor) ~ Yes C4~iQo CISTERN la Yes o
(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 ~ Laundry tub O Sanitary sewer,,,,_„ ~ Outside
at Inspection: ~ Floor drain ~ Other
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Prior to Inspection:
When was stem installed, or most recently modified? (Date) and why
ome came with system ~ Response to inspection program ~ Other
O Water in basement ~ Previous syste ailed
B. ROOF LEADERS: ~7 Yes o DISCHARGE: l7 Near O Away
C. YARD DRAINS Yes ~ ~` VYINDOW WELLS Q Yes I"~" No
BEAVER 5YSTEM ~ Yes ~L'NO
D. PROPERTIES WITH 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? la Front Q Back C] Side
NOTES:
SUMP PUMP SYSTEM: ~ASS ^ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready jar reinspection, call 651/644-1469 for an appgintment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes Q~'iQo
Where is this loeation?
This area will need to b ed,se~the clear~vate,r~scharges to the storm sewer system.
Inspector: ,,--~-~" • ~r %~~~if `"`---' Date: /~ ~' ~
Resident: ' ~. ~""!"'~-T'_-° ~_.... Date: ~
Disclaimer: This yisual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all City Codes.
~ / s~~y
Name: /~~~1 ",L~~-~4rt,~ C /.~~~~/~ Date;~i~/- ~.~ Time:~~~a.m./p.m.
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White: Homeowner Yellow: City Pink: .HRG