HomeMy WebLinkAboutSump Pump InspectionOF PRIp~
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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ~,~,~J;
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Name: ~ ~i'h~~vcr~~~ ~_ 1~~~~ Dat~ ~~C'~.~Time~~~a.m./p.m.
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/~,,. f ~~"~'~ First In~s~p~e ' n ~cond ~ ~~
Address: /~,J ~v~~ ~ ~~~L~~>~ 1~~ Own: f~' Rent: Age of Home: ~" 7' ~
~~/ Residential: ~ ,,~
Prior Lake, MN 55~~.~ Phone~:T`~ `~~77 Non-Residential: ~
A. BASEMENT ~'i~es ~ No~ SUMP BASKET D Q~ ~ L~ 2~ 3 ~
WATER IN BASKET 17 Yes o SiJMP P U N~~ B' 0~ 1 ~ 2 ~ 3 ~
WATER IN BA5EMENT (flow over floor) ~ Yes t~o CISTERN ~ Yes ~,Pd~~
(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 Poini ~ Laundry tub ~ Sanitary sewe~ ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection: ""
When s system installed, or most recently modified? (Date) and why
LL~"' Home came with s stem ~ Res onse to ins ection ro ram ~ Other
Y P P P S
O Water in basement ~ Previous syste failed
B. ROOF LEADERS: ~ Yes L~~~1o DISCHARGE: U Near ~ Away
C. YARD DRAINS ~ Yes ~~~''~~" WINDOW WELLS ~ Yes ~~fo
BEAVER SYSTEM ~ Yes IJ'"No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer Cl Sprin~. a Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front 17 Back ~ Side
NOTES:
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SUMP PUMP SYSTEM: I~ASS ~i FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651/644-1469,j'or an ap iument.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C~No
Where is this location?
This area will need to b ed,,s~the clear }~later,,~scharges to the storm sewer system.
Inspector:
Resident:,
Date: ,,.j -•G' o -
Date:~-2~'-
I Disclaime~C~'his visual inspe+ction is done with due diligence to find obvious clear water cross-connections I
and does not imqlv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG