HomeMy WebLinkAboutSump Pump Inspection
Name:
City of Prior Lake
Sump Pump and III Reduction
Inspection Form
pru( -s~ Bv.... rtC' J 1 Date: :? ..../ g. Cf4 Time: 2 : oO.a.m~ >
Address: 2 '8"50 5(Jr{ ~ LLl te (20/
First Insp~ction ~ Second 0
Own: ~ Rent;Jj Age of Home: /2 'f. (5
Residential: lJJ"'" '
Non-Residential: 0
Prior Lake, MN 55372- Phone:
A. BASEMENT ~s CJ No / SUMP BASKET ~ 0 1 CJ 2 CJ 3 CJ
WATER IN BASKET CJ Yes l!f No SUMP PUMP ~ CJ 1 CJ 2 CJ 3 CJ
WATER IN BASEMENT (flow over floor) CJ Yes l3-No CISTERN CJ Yes ~o
(If no pump, place sticker across edge of sump cover and basement'~or so any removal of cover will
break seal. Skip to Part B of this form.) """
Discharge Point CJ Laundry tub CJ Sanitary sewer '''-.''' CJ Outside
at Inspection: CJ Floor drain CJ Other '-
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
CJ Home came with system
LJ Water in basement
CJ Response to inspection program CJ Other
LJ Previous system failed
lB"Yes 0 No DISCHARGE: CJ Near ~ Away
CJ Yes ~No WINDOW WELLS 0 Yes ~o
o Yes a:Y'No
B.
C.
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
D.
PROPERTIES WITH SUMP PUMPS
When does pump run? CJ Fall CJ Summer CJ Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? CJ Front CJ Back
CJ Winter
CJ Side
NOTES:
SUMP PUMP SYSTEM: )'<PASS 0 FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651/644-1469 for an appointment.
r- Is there another place where clear water enters the sanitary sewer system? JZf' Y es ~o
Where is this location?
This an!a will nee9J~ fixed JO th; clear water discharges to the storm sewer system.
Inspector: /~ .~~ /J Date: (' - K - CJ'J
Resident: .If, ~ ~ /~ ~ -. Date:
. J
~
Disclaimer: This. visual inspection is dc\ne with due diligence to fmd obvious clear water cross-connections
and ,does not imply the structure meets 'all City Codes.
White: Homeowner
Yellow: City
Pink: HRG