HomeMy WebLinkAboutSump Pump Inspection~ ~.:
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: ~ ~,~~~ ~„ Date: ~ y- ~~1 Time: .;~G~ a.n
D~'Yl ~/ l,l.- ~ , ,, ~'' ' ' ~-
First s ction~ Second L7
Address: ~y D~ ,S`/f7(~!/ ~, ,~'~~L/ ~t..1y~E Own: I~Rent: Age of Home:
Residential~
Prior Lake, MN 55__ Phone: . , Non-Residential: ~
A. BASEMENT Yes I~ N~/ ~~~ 5UMP BASKET ~ 0 O 1 ~ 2 ~ 3 ~
WATER IN BA T I~ Yes Q No SUMP PUMP ~ 0 ~ 1 ~ 2 Q 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN ~ Yes~No
(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 O Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
B.
C.
D.
NOTES:
SUMP PUMP SYSTEM:
~ Spring ~ Winter
~ Back
Q Side
~ PASS C] FAIL You have 30 days to bring your system into comp[iance 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? ~ Yes ~ No
Where is this location?
This area~,~I' nee be fixed so t~lear water dis~har~to the storm sewer system.
Resident:
Date: /p .
Date:
I Disclaimer: This ~al inspection is done with due diligence to find obvious clear water cross-connections I
and does not imnlv the structure meets all Citv Codes.
When was system installed, or most recently modified? (Date) and why
O Home came with system ~ Response to inspection program ~ Other
Q Water in basement C7 ,Previous system failed
ROOF LEADERS: ~Yes ~ No DISCHARGE: ~ Near Away
/~
YARD DRAINS ~ Yes No WINDOW WELLS ~ Yes~No
BEAVER SYSTEM O Yes No
PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
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White: Homeowner Yellow: City Pink: HRG