HomeMy WebLinkAboutSump Pump Inspection,~
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form ,,~,~,~~r
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Name: ~.~ Q.~ ,~~.~Vi'~~ Date:~ J~ ~9 Time;~,.3,~Oa.m./p.m.
'/ ,/ ~irst In_~sp~e ' n ~"' Second ~
Address:,~'Y301 ~~/~Q~ ~~f~C/v~ r,~ N,~.Own: ~' Rent: ~ ge of Home: ~~
`/ Residential: ~ ~
Prior Lake, MN 55 ~~~~ Phone:`Y~lv- ~~~ Non-Residential: ~
!_ _~ , l'~'~,~ ~ -
A. BASEMENT t~es ~ No_ /~ SUMP BAS 1 C] 2~ 3 I~
WATER IN BA5KET ~ Yes CD~Qo SUMP P 0 a 1 ~ 2 ~
WATER IN BA5EMENT (flow over floor) O Yes o CISTERN a Yes 1~~
(If no pump, place sticker across edge of sump eover and basement floor so any removal of cover will
break seal. Skip to Part B of this form.)
Discharge Point a Laundry tub ~ Sanitary sewe~ ~ Outside
at Inspection: Q Floor drain d Other
Prior to Inspection: ~
When was systern insta.lled, or most recently modified? (Date) and why
~ Home came with system O Response to inspection program a Other
Q Water in basement O Previous syst ailed
B. ROOF LEADERS: ~ Yes o DISCHARGE: ~ Near ~ Away
G YARD DRAINS ~ Yes l~~'~N WINDOW WELLS ~ Yes o '
BEAVER SYSTEM ~ Yes ~No .
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring O Winter
(check all that apply) How often does pump run? -~'~
V~here does pump discharge to outside? ~ Front O Back ~~ Side
NOTES:
SUMP PUMP SYSTEM: L~YPASS Q FAIL You have 30 days to bring your system into compliance with current
regu[atiorrs. When you are ready for reuupection, ca11651 /644-1469 for an tntment.
Is there another place where clear water enters the sanitary sewer system? Q Yes Q~No
Where is this location?
This area will need to b x the clear ate ischarges to the storm sewer system.
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Inspector: ! ~-~' •
Resident: c~••~--~-•---
Date: ti-~~`
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: ARG