HomeMy WebLinkAboutSump Pump Inspection~/~ ~F PRIp~'
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~o;~ )7--
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Name: ~~~/V~~N'~ ~ ~~/ Dat~~7"~~Tima~~~~m./p.m.
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~ ,~Z G~ ~ First Inspe 'on ~" Second ~ /J `
Address: ~~ ~'~''~ d~ ~''~~ Own: Rent: Age of Home:e~/~
~y~~ Residential: ~ -.
Pripr Lake, MN 55 ~/~ Phone>''~~ ~~~~ Non-Residential: ~
A. BASEMENT L7~''~es~~~llys~'~ SiTMP BASKET ~ 0 ~.~~,~'"2 l7 3~
WATER IN BASKET +~ ~ No SUMP~]V~~ O 0 ~~~ ~ 2 O 3
WATER IN BA5EMENT (flow over floor) O Yes o CISTERN O Yes ~
(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 ~ Laundry tub ~ Sanitary sewer utside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection: _~.
~` When w stem installed, or most recently modi~ed? (Date) and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basemen CI Prev' us system failed
B. ROOF LEADER5: ~~ ~~ es ~ No DISCHARGE: Q Near ~~~
~ ~~~ ~ ~
C. YARD DRAINS Q Yes Q~ N~o-~'~ WINDOW WELLS ~ Yes @~'1Qo
BEAVER SYSTEM O Yes L~~1Vo
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall ~ Summe~ 7~~g ~Q Winter
(check all that apply) How often does pump run. ~f ~9/til ,~/C-`~1.~ ~
V~Fhere does pump discharge to outside? L7 Front ack~ ~ Side
NOTES:
SUMP PUMP SYSTEM: I~ASS O FAIL You have 30 days to bring your system into compliance with curr
regulations. When you are ready for reinspection, ca11651 /644-1469 for an tnt»tent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this location?
This area will need to b ixe the clear~afater~har~s to the storm sewer system.
Inspector;
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