HomeMy WebLinkAboutSump Pump Inspection!
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~~,~ ~
Name: /~~/.C` T fi,s~ ~~N Date:~%'~"~~ Time~/7-~~.m./p.m.
'/ ~(0' ~..~~First In~s~p~ec ' ~ Second Q
Address:~'S`~~8 ~U/~~~1~~~~ /~% Own: I~ Rent: ~- Age of Home:~~
~y `,~ / L~~ Residential: ~ ~
Prior ~.,ake, MN 55 ~/~ Phone' Y~~ ~~~" 7 ~ Non-Residential: ~
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A. BASEMENT es ~ No SUMP BASKE 1~ 2 Q 3 ~
WATER IN BASKET t7 Yes o 5UMP P 0 Q 1 ~ 2 ~7
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN Q 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 ~ Sanitary sewer Q Outside
at Inspection: ~ Floor drain ~ Other "-~
~ Prior to Inspection: ..~---
When was system installed, or most recently modified? (Date) and why
d Home came with system l~ Response to inspection program ~ Other
~ Water in basement O Pre ' s system failed
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B. ROOF LEADERS: ~~f 1 ~ p Yes ~ No DISCHARGE: ear ~ Away
G YARD DRAINS a Yes L~~~'N/o ~ WINDOW WELLS d Yes ~
BEAVER SY5TEM ~ Yes ~iNo
D. PROPERTIES WITH SUMP PUMPS
When does pump nzn? O Fall a Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
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SUMP PUMP SYSTEM: C1~'~ASS ~ FAIL You have 30 days to bring your system into comp[iance with current
reguladons. When you are ready for reinspection, call 651 /644-1469 for an ap ' ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need t e so lear wat r' arges to the storm sewer system.
Inspector: Date: - p"
Resident: Date: ~. - ~ -
Disclaimer: This visual inspection is done with due ' ence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG