HomeMy WebLinkAboutSump Pump Inspection~F PRIp~,
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City of Prior Lake
Sump Pump and I/I Reduction
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ction Form ;~~,~ ~~
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Name: ~~~~ , ~ ~~Q/~ ~ Dat~"~~ ~~ Ti~~ .m./p.m.
~~ First In,~s~P ion ~' Second ~
Address~~~ ~~~~~~ ~~~ Own: P~ Rent: A e of Home:~ ~
g
,(~~,r~ Residential: ~
Prior ake, MN 55~~~ Phone":~'~~`9~~~ Non-Residential: ~
A. BASEMENT es~o SUMP BASKET ~ 0 1~ 2 ~ 3 17
WATER IN BASKET es , O, No SIJMPCPU~P~ ~'6~~~ 1~ 2~ ~
WATER IN BA5EMENT (flow over floor) ~ Yes I'1Go CISTERN ~ Yes o
(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 Q Outside
at Inspection: ~ Floor drain ~ Other '~
B.
C.
D.
NOTES:
Prior to Inspection: ---''""
When as system installed, or most recently modified? (Date)
and why
Home came with system ~ Response to inspection program ~ Other
~ Water in basement
ROOF LEADER5: ~
~ Previous system failed
Yes ~ DISCHARGE: ~ Near
O Away
YARD DRAINS ~ Yes WINDOW WELLS ~ Yes C~''No
BEAVER SYSTEM ~ Yes No
PROPERTIES WITH SUMP PU1V~S
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
SUMP PUMP SYSTEM: C'~PASS ~ FAIL You have 30 days to bring your system into compliance with current
regutadons. When you are ready for reinspection, call 651 /644-1469 for an intment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~ No
Where is this locati .
This area will need o b ed e lear w r' c rges to the storm sewer system.
Inspector: ,~--l~a.,~~~"~~`''''--..,---''' _ Date: ._..~-~~ -
Resident: ~ ~.,1~,,~c~., c. ~~_'~"'L~~' 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.
~ Spri~ Q Winter
~ Back ~ 5ide
White: Homeowner Yellow; City Pink: HRG