HomeMy WebLinkAboutSump Pump Inspection~F PRIp~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~~P~ ;
~J,~ /'~~-~ ~ Date~'~~"~~ Time:~~~~.m./p.m.
~ ,,./ ~~~~~ ~~ ~~,,, First In_~spe~c,t3'~~ L~'" Second ~ ~ }~~
Address: ~~ ~~~ Own: f~''Rent: ~ ge of Home.1 ~4
Prior Lake, MN 55 3~~'
~/,/ Residential: ~ ,;,,
Phone•.`~"`~`~'~~~'~' Non-Residential: ~
A. BA5EMENT ~ Yes ~fo~ ~ SiJMP BASKET ~L'_T~ ~ 1 ~ 2 ~ 3 O
WATER IN BASKET ~ Yes l~No SiJMP _P~~~ 'Q 0~ 1 ~ 2~ ~~~3-%- a
WATER IN BASEMENT (flow over floor} a Yes ~ N o CI5TERN ~ Yes E~' N o
(If no pump, place sticker aeross~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:
~ Laundry tub I~ Sanitary sewer ,._.-~ Outside
a Floor drain ~ Other
Prior to Inspection: `y~
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Res onse to inspection program ~ Other
O Water in basement ~'ous system failed
B. ROOF LEADERS ~,~` ~ Yes ~ No DI5CHARGE: Q Near ~~
C. YARD DRAINS ~ ~ Yes ~ 7~'~~ WINDOW WELLS ~ Yes L"~ No '
BEAVER SYSTEM ~ Yes L9~No
NOTES:
D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall O Summer ~ Spring
(check all that apply) How often does pump run? '"'""-
V~here d es pump discharge to outside? ~ Front ~ Back
- -•---•-•-•-•-~-•-----•-•-•-•-•-•-•-----~- -----•-•---•-•-•-•-•-• ~--•-
f~ii~'J,f~.
~ Winter
_ I~ Side-•---•-•-•---•-•-•-•-
SUMP PUMP SYSTEM: A~'PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When yau are ready for reinspection, ca[l 651 /644-1469 for an appo nt.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~~'No
Where is this location?
This area will need to b ixed he clear w ter ` arges to the storm sewer system.
Inspector: Date: ' ~3 - ~
Resident: Date: - ~3 -
Disclaimer: Th' sual inspecti n is ne with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner
Yellow: City
Pirik: ,HRG