HomeMy WebLinkAboutSump Pump Inspection^ +J
~.`~~
`J
~~ ~~'~
, ~~`
~j
~ ~
City of Prior Lake
Sump Pump and I/I Reduction
.
Ins~ection Form ~. ,~~ .~-~ .
~
Name : ~c~ ~, v~~ .~ ~~ ~ k i ~ ~; ~ ,- ,- ~' ~- Cu, -~--~ ~ r ~ Hc
Address: /~/.; yp ~ ~ F~ ~ r J.,.~"G ~~~ 7r ~~ lU F
Prior Lake, MN 55 ?.7,,;~ Phone: ~/~/.~ - ary.,27y
Date: ~~- /..~ -`~ 9 Time: Q~D o a.m./p.m.
First Inspection ~
Own: ~' Rent: ~
Residential: ~''
Non-Residential: ~
Second ~
Age of Home:~
c,..ir /k ~ „~ ~ /
A. BASEMENT 13'Yes ~ No 5iJMP BA5KET t~' 0~ 1 O 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ No 5UMP PUMP ~ Q 1 ~ 2 a 3 ~
WATER IN BASEMENT (flow over floor) 17 Yes ~ No CIS1'ERN ~ Yes f~-IQo
(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 ~ Sanitary sewer ~ Outside
~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
D Home came with system ~ Response to inspection program ~ Other
Q Water in basement ~ Previous system failed
B. ROOF LEADERS: ~s ~ No DISCHARGE: ~ Near C~" Away
C. YARD DRAINS ~ Yes ~'~1o WINDOW WELi,S ~' Yes a No
BEAVER SYSTEM ~ Yes ~-~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? a Fall ~ Summer ~ Spring I~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ta Back O Side
NOTES:
SUMP PUMP SYSTEM: PASS I~ FAIL You have 30 days to bring your system into comp[iance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes I~~To
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~ ~ ,~ Date: _~ /~ - 9 9
Resident: ~~.<.~,t..e, ~~,~.~,,C' Date: S" - f~? - 9 9
,
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