HomeMy WebLinkAboutSump Pump Inspection~~
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ection Form
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~ Name: ~,~~~~~ / ' I i~~ /S~ Date: '~f ~~Time~~~aa.m./p.m.
~ (~~ ~ ~/ First In~spfe~~ n ~nd ~ Q
Address: ~~J9,~~ ~,J~O.~'.~ //~ /t/~ Own: ~' Rent: Age of Home: ~/ ,
p Residential: ~ ~
Prior Lake, MN 55 ~~~ Phone ~U~ Non-Residential: ~
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A. BASEMENT es L7 No~ SiJMP BASKE ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes o SIJMP P 0~ 1 ~ 2~[7
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ 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
at Inspection:
B.
C.
D.
NOTES:
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous syst ailed
ROOF LEADER5: D Yes o DI5CHARGE: ~ Near Q Away
YARD DRAINS ~ Yes L~~~~~ WINDOW WELLS C] Yes ~~o
BEAVER SYSTEM ~ Yes [~No
PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring D Winter
(check all that apply) How often does pump run? ~----
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
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SUMP PUMP SYSTEM: ~PASS ~ FAIL You have 30 days to bring your system into compliance with curren
regulations. When you are ready for reinspection, ca![ 651 /644-1469 for an ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b ix~ed:ao the clea~a~charges to the storm sewer system.
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Inspector:
D oo;.io..t
Date: ~`-r- ,
Date: ~
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.
City of Prior Lake
Sump Pump and I/I Reduction
~ Laundry tub ~ Sanitary sewer tJ Outside
~ Floor drain L~ Other "'
White: Homeowner Yellow: City Pink: HRG