HomeMy WebLinkAboutSump Pump Inspection~'
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City of Prior Lake
Sump Pump and IiI Reduction
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Inspection Form ~~'~'
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r~~- ~Q /.~ Date: ~`'~ ~~ Time~ d.mJp.m.
/,~ , (~~~~ -,--' / /~ First Inspe ° n ~nd ~ ~~ ~~
Address: ~'~7'~~ ~~ ~~ ~t~ Own: Rent: ~ Age of Home:
~y ~ 2 ~-,~~ Residential: ~~
Prior Lake, MN 55 ~/~ Phon~~~ ;~v _^ Non-Residential: ~
A. BASEMENT ~ Yes ~'iVo~ SiJMP BASKET ~~/f1 1~ 2 ~ 3 ~
WATER IN BA5KET O Yes o SiJMP~~~~ ~~0 ~ 1 ~ 2 ~ 3
WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes
(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 ~l. ._Outside
at Inspection: ~ Floor drain ~ Other ~
Pribr to Inspection: `~
When was system installed, or most recently modified? (Date) and why
~ HoYne came with system la Response t inspection program ~ Other
~ Water in basement O Previ system failed
B. ROOF LEADER5: es ~ No DISCHAR~E: I~ Near way
C. YARD DRAINS ~ Yes No WINDOW WELLS ta Yes'~"No
BEAVER SYSTEM ~ Yes I~1Qo ~
D. PROPERTIES WITH SUMP PUIVIPS
When does pump run? ~ Fall ~ Summer ~,S?mitg ~ Winter
(check all that apply) How often does pump run?
V~here d s pump discharge to outside? ~ Front ~ Bac O Side
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NOTES: LJ ~! ,~
SUMP PUMP SYSTEM: E'~" PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[I 651 /644-1469 for an appointment. ,,,..-
Is there another place where clear water enters the sanitary sewer system? Q Yes
Where is this location?
This area will need to be ed~,ser'~he clear }~ater~harges to the storm sewer system,r
Inspector: ~""'~ Date: -~ /'
Resident: . , , Date: ~-- ,,;Z~
Disclaimer: This vi~ual~p~ction is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all City Codes.
White: Homeowner ' Ye11ow: City Pink: HRG