HomeMy WebLinkAboutSump Pump Inspection~ ~F PRIp~
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City of Prior Lake
Sump Pump and I/I Reduction
ction Form ,q~,~ ~ ~
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Name: ~~~~.~ ~ ~ 7~i~r ~~ Dat~ ~ ~/ Tim~~~.m./p.m.
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~.,1~ ~~ ~~Q ~ ~ First In~sp~ on L~'' Second ~ ~
Address:~~~~~/``! ~ Own: Q" Rent: Age of Home~ ~
.~y ~/ ~~ Residential: ~ •~
Prior L~ake, MN 55 ~/~ Phone`?`~~%~'~~~ Non-Residential: ~
A. BASEMENT es ~ No~ SUMP BAS ~ 1 ~ 2 O 3 ~
WATER IN BASKET ~ Yes o SUMP P 0 O 1 ~ 2~~17
WATER IN BASEMENT (flow over floor) D Yes o CI5TERN ~ 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 Q Laundry tub d Sanitary sewer O Outside
at Inspection: ~ Floor drain ~ Other ~
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Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program D Other
Q Water in basement p~e 'ous system failed
B. ROOF LEADERS ~~ ~ Yes f7 No DISCHARGE: ~ Near way
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C. YARD DRAINS ~ Yes [~"~N ~ WINDOW WELLS Q Yes o
BEAVER SY5TEM ~ Yes ~~''No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spri~ ~ Winter
(check all that apply) How often does pump run?
VVhere does pump discharge to outside? la Front O Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~I'ASS ~ FAIL You have 30 days to bring your system into compliance with cur
regutations. When you are ready jor reinspection, ca[1651 /644-1469 for an ointment.
Is there another place where clear water enters the sanitary sewer system? Q Yes o
Where is this location?
This area will need to be d~ clear wat~iscl~s to the storm sewer system.
I Inspector: , /~` ` - `------- Date: ..~ -G = 7 7 I
Resident: ~ , 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
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Pink: HRG '•