HomeMy WebLinkAboutSump Pump Inspection~ ~ aF PRlo~
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City of Prior Lake
Sump Pump and I/I Reduction
.
ectlon Form ,~,~~~
Name: J~~~~~+~~50~! ~.~~~~ Date:~ ~'~~ Time~O~~a.m./p.m.
~/~p 9~ GG ,~,,,,~.~,,,~ ,~' ~'7, ~,. First In~s~ ion Second ~
Address: '~ ~ ~ t~- , Own: I~ Rent: Age of Home: /'`
I`~y Residential: ~
Prior Lake, MN 55 ~/~.~ Phone: ~'Y /~~i~~~ Non-Residential: ~
, , ~
/s,,, v w c:. ~c. n.
A. BASEMENT es ~ No~ SiJMP BASKET Q 0 1~ 2 ~ 3 L?
WATER IN BASKET ~ Yes o SUMP C~~ 0 Q 1 ~ 2~~
WATER IN BASEMENT (flow over floor) ~ Yes o CI5TERN O 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
at Inspection:
~ Laundry tub Q Sanitary sewer ,.,....-~ Outside
O Floor drain ~ Other
Prior to Inspection:
When s system installed, or most recently modified? (Date) and why
~e came with system ~ Res onse to inspection rogram ~ Other
P P
Q Water in basement Q Pr ious system failed
B. ROOF LEADER5: ~' Yes ~ No DI5CHARGE: ~ Near t~' Away
C. YARD DRAIN5 Q Yes ~~' N~ WINDOW WELLS Q Yes ~No
BEAVER SYSTEM ~ Yes I~/No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? r-
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
~~ - - -•------- - -------•---•- - -•-•---------•-•---•-•--- - -•----- - ------------- p
NOTES• ~E~ /S CD~t/~E~E'ti/.E'D ~7.BOU 7' ~~,:~' ,~ut.c.O - u /~-•-•-•-----•-•-•-
~'?~F..~ 7 c~ ~~"c ~` ~C ~ 4 7~~. ~~/v,~ -~N .~- o E~
SUMP PUMP SYSTEM: l~'~ASS L~l FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[l 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~~~o
Where is this location?
This area will need to be ed s e c1Ear ater ' charges to the storm sewer system.
Inspector: Date: ~ ~
~ Resident:~ ~.,, ~'~ ~~ ~ ir ,~,r~,.~.~-,~~r--~~ ~ Date: ,,2-r• -$~ ~ ~
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