HomeMy WebLinkAboutSump Pump Inspection Program
Name: P ( C1 s c ~ .
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City of Prior Lake
Sump Pump and III Reduction
Inspection Form
AvVV\;V\.
Date: '1-;;1- 17 Time:ll./5- a.m./p.m.
First Inspection ar" Second 0
Own: ~Rent: 0 Age of Home:.-?o r
Residential: 13"
Non-Residential: 0
Address: 'I;2..J J 0 CA"i Itn 71' /. IJ F
Prior Lake, MN 55 J 7..J
Phone:
BASEMENT 0 Yes ~o
WATER IN BASKET 0 Yes 0 No
WATER IN BASEMENT (flow over floor)
A.
SUMPBASKET ~. 0 1 0 2 0 3 0
SUMP PUMP ~O 0 1 0 2 0 3 0
o Yes I31'fu CISTERN 0 Yes l31'fo
(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:
o Laundry tub
o Floor drain
tJ Sanitary sewer
o Other
o Outside
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
o Home came with system
o Water in basement
PROPERTIES WITH SUMP PUMPS
When does pump run? 0 Fall 0 Summer 0 Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? 0 Front 0 Back
B. ROOF LEADERS:
C. . YARD DRAINS
BEAVER SYSTEM
D.
o Response to inspection program
o Previous system failed
o Other
l3""Yes 0 No
o Yes I3""No
o Yes ~No
DISCHARGE: 0 Near ~Away
WINDOW WELLS 0 Yes ~No
o Winter
NOTES:
-.-------------------.-.-.-.---------------.---------------.---------------------------------------.-----------------.---.-.-----.-
o Side
-
~ ASS 0 FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection. ca[[651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? 0 Y es ~ No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
- .
Inspector: / ()h:.1 A.-1J"rrv "L Date: 'I-.J 1- 17
Resident:{d i4/......-r~ tp ((f-.A/.cL Date: '/-JI- 91
SUMP PUMP SYSTEM:
Disclaimer: This visual inspection is done with due diligence to rmd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG