HomeMy WebLinkAboutSump Pump Inspection% J
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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
Name: G~~1 !~ /" I ~~ r ~/
~
Address: / ~~.~ ~ ~ ~ 1, o~e ~. n . /~ ~
Prior Lake, MN 55 3 7,~ Phone: ~ yG- ,s'~ ~~'
Date: ~ ~~%-~1~J Time: 7>~a.m./p.m.
First Inspection ~
Own: t~'" Rent: ~
Residential: [a-''
Non-Residential: ~
Second ~
Age of Home:~
~ , k.~. t , ~~/
A. BASEMENT ~-#'4es ~ No SUMP BA5KET Q 0 C~ 1~ 2 ~ 3 ~
WATER IN BASKET ~es ~ No SIJMP PUMP ~ 0 ~~ 2 ~ 3 Q~
WATER IN BASEMENT (flow over floor) ~ Yes L~'1Qo CISTERN ~ Yes C-I'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
at Inspection:
CI Laundry tub ~ Sanitary sewer l~ Outside
~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) J 9~~ and why
~ Home came with system ~ Response to inspection program ~ Other
~-''Water in basement ~ Previous system failed
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a
B. ROOF LEADER5: l~
es ~ No DISCHARGE: C~ Near Away
C. YARD DRAINS ~ Yes Q'T~Vo WINDOW WELLS ~ Yes t~'1~fo
BEAVER SYSTEM 17 Yes l~fi[o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer ~ Spring O Winter
(check all that apply) How often does pump run?
V~there does pump discharge to outside? I~ Front ~ Back ide
NOTES:
SUMP PUMP SYSTEM: ~'PASS ~ FAIL You have 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, ca[[ 657/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C~'T~o
Where is this location?
This area will need to be ~xed so the clear water discharges to the storm sewer system.
Inspector: ,,a. ~~.-- Date: ~ ~ ~~ - ' 9
Resident: Date: .~- /~- 99
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