HomeMy WebLinkAboutSump Pump Inspection~ OF PRIp
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City of Prior Lake
Sump Pump and I/I Reduction
Inst~ection Form
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Name: /~/ ~~~~~ ~NN i~ - Date;~"~~" ~/ Time~O~Da.m./p.m.
' O ~ --~~', ,~~/ First In~spe~c,tJ'~~ ~'" Second ~ ~
Address: ~~ /~~/~ ~' /~- lV Own: t~'' Rent: Age of Home. ~
,,,,,'/ Residential: ~ ~
Prior Lake, MN 55~~~ Phone. ~-'S~~~~ Non-Residential: ~
A. ~ BASEMENT ~s ~ No~ ~ SUMP BASKET ~~/~ 1 ~ 2 l~ 3~
WATER IN BASKET O Yes C~'No SiTMP~P~~ Pd~O ~ 1 Q 2~ ~~' C~
WATER IN BASEMENT (flow over floor) ~ Yes QyNo CISTERN ~ Yes 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 17 Laundry tub ~ Sanitary sewer ~~ Outside
at Inspection: ~ Floor drain ~ Other
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Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
~ Home came with system Q Response to inspection program ~ Other
Ca Water in basement C? Pre ' us system failed
B. ROOF LEADERS: ~~D~~~' Yes ~ No DISCHARGE: ~ Near way
f ~' 1 ~ ~~ /~
C. YARD DRAINS C7 Yes ~~N~ WINDOW WELLS ~ Yes l~1Qo
BEAVER SYSTEM ~ Yes CD~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring,,., ~ Winter
(check all that apply) How often does pump run? -''~
V~here does pump discharge to outside? ~ Front I~ Ba~ck ~ Side
NOTES: ~
SUMP PUMP SYSTEM: 1~`PASS ~ FAIL You have 30 days to bring your system iruo compliance with current
regutadons. When you are ready for reinspection, ca[l 651 /644-1469 jor an ntment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to be,~ed s~he clear w~er cji~charges to the storm sewer system.
Inspector:
Resident:
Date: "ti'"/ ~
Date: -
I Disclaimer: T~isual i~is fiection is done with due diligence to find obvious clear water cross-connections I
and does not imnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG