HomeMy WebLinkAboutSump Pump Inspection°"' i ~
~~,~ ~' :'• =°-a ,:~i't % ~ "l~,~
.~~> r~ w~ ~ ~'
City of Prior Lake
Sump Pump and I/I Reduction
Inst~ection Form
Name: ~ ) D L~~.~~ ~J~~I~T/~`~
Address:~ ~~0~ ~ f~`/9'"~ ~ 1,~~170/1~7~
Prior Lake, MN 55 Phone: ~ ~
Date: /'p' //-9 ~' Time: ~d . Jp.m.
First Inspection ~ Second ~
Own: ~ Rent: t7 Age of Home:,~
Residential: ~
Non-Residential: ~
~V~3-~ ~ ~' t~ F- v ~- a.i
A. BASEMENT Yes ~ No 5UMP BASKET 0 O 1 ~ 2 ~ 3 ~
WATER IN BAS T~ Yes Q No S PUMP 0~ 1 ~ 2 3~
WATER IN BASEMENT (flow over floor) Q Yes No CISTERN ~ Yes o
(If no pump, place sticker across edge of sump cover and basement floor so any remov 1 of cover will
break seal. Skip to Part B of this form.)
Discharge Point L7 Laundry tub ~ Sanitary sewer Q Outside
at Inspection: L'7 Floor drain t~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
Q Home came with system L~ Response to inspection program ~ Other
~ Water in basement Q Pr vious system failed
B. ROOF LEADERS: ~ Ye No DISCHARGE: ~ Near ~ Away
C.
D.
YARD DRAINS ~ Ye No WINDOW WELLS ~ Yes No
BEAVER SYSTEM ~ Yes No
PROPERTIES WITH 5UMP PUMPS
When does pump run? O Fall d Summer Q Spring
(check all that apply) How often does pump run?
V~Fhere does pump discharge to outside? a Front ~ Back
NOTES:
Q Side
L~K''c
SUMP PUMP SYSTEM: ~PASS I~ FA~u ha e~y~' o~~ y~r system in~to ~ iane~e w'i ie current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes Q' No
Where is this location? ~~~
This area w~Ll-nt~d to be fixed so th~.~clear water dischayge~ to the storm sewer system.
Resident:
Date:
Date:
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imulv the structure meets all City Codes.
Q Winter
White: Homeowner Yellow: City Pink: HRG