HomeMy WebLinkAboutSump Pump Inspection~ ~ C~ F PRIp
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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
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Name: / -/ / ~~~i~i ~.~ ~i~/~•C ~ Date ~ ~~ ~~ Time07~ ~m. /p. m.
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,~y ~~ ~~ First In~~s~p,~ on ~ Second ~ ~/
Address:~~~ /~ `l//-G.~COG(1 ~.t ~Q~;,N /~c.. Own: L~J' Re_~nt~:,~`' Age of Home~ /
~y`/~s~ / Residential: L~Y y
Prior Lake, MN 55~/~ Phone:7'~Qiv~lp Non-Residential: ~
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i v~ - - -- --- -~.~
A. BASEMENT es~ SiJMP BASKET ~ 0 1~ 2 ~ 3 ~
WATER IN BASKET es ~ No SUMP P~IP 0~ 1 ~ 2 ~~-~
WATER IN BASEMENT (flow over floor) ~ Yes ~No CI5TERN ~ Yes L~~~
(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 O Sanitary sewer ~ Outside
at Inspection: I~ Floor drain ~ Other ~-
Prior to Inspection: ~,.---
Whe as system installed, or most recently modified? (Date) and why
Home came with system ~ Response to inspection program ~ Other
Q'~ Water in basement ~ Pre ' us system failed
B. ROOF LEADERS: 19'Yes ~ N DI5CHARGE: ~ Near Cl~2rwa
Y
C. YARD DRAIN5 ~ Yes ~~~ WINDOW WELLS ~ Yes ~
BEAVER SYSTEM ~ Yes L~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall Q Summer I] Sprin ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? O Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~PAS$ ~ FAIL You have 30 days to bring your system into com,pliance with current
regulations. When you are ready for reinspection, ca11651/644-1469 for an intment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~" No
Where is this location?
This area will need to be ed~e clear w~er d~harges 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