HomeMy WebLinkAboutSump Pump Inspectionr ''~'~~~~ ~~~
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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
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Name:~~.~.f~ ~~ )~,y,~r~` Date: ;,,~~ `~1 ~Time: (1 a.mJ .m.
First Ins ection ~ Second ~
Address~~~„}rr~ ~//'/~/ ~G./Q/1~~ Own~ n: l7 Age of Home:
Residential.-R~
Prior Lake, MN 55 Phone: Non-Residential: ~
A. BASEMENT L~ Yes ~ No SiJMP BASKET ~ 0 ~ 1 ~ 2 ~ 3 ~
WATER IN BA5KET ~ Yes ~ No SUMP PUMP Q 0 ~ 1 ~ ~ 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~ No CISTERN d Yes No
(If no pump, place sticker across edge of sump cover and basement floor so any remova of cover will
break seal. Skip to Part B of this form.)
Discharge Point ~ Laundry tub ~ Sanitary sewer 17 Outside
at Inspection: O Floor drain a Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system L~ Response to inspection program ~ Other
O Water in basement I~ Previous system failed
B. ROOF LEADERS: ~ Yes Q No DISCHARGE: O Near a Away
C. YARD DRAINS Q Yes ~ No WINDOW WELLS ~ Yes ~ No
BEAVER SYSTEM ~ Yes ~ No
D. PROPERTIES WITH SUMP PUIVIPS
When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? O Front 0 Back 17 Side
NOTES:~- - ---•-•-•-•------- - - - --- - - -•~~.~'` ~-•-•-•---•-•-•-----•-•-----•-•~-• ~-~-C-•- -
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5UMP PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca!! 651/644-14 9 for an appointment.
Is there another place where clear water enters the sanitary sewer system? O Yes No
Where is this loc on?
This area wi eedrt b~ed so the clear_water cjiech~rges to the storm sewer system.
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Resident:
Date: _~,
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.
White: Homeowner Yellow: City Pink: HRG