HomeMy WebLinkAboutSump Pump Inspection~ ~ QF PRIp
~i ~ ~
U ~
City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name:~~~~~`~~~~~ /~2~2`~ Date:~,~'-~ g~ Time,~~3~m./p.m.
~1~ ~ ~/
/ First Inspecti ~'~econd ~
Address: ~~CO~~ ~ ~ -~! ~ ~-~ ~`~n ~U Own: ent: ~ Age of Home: ~ ~
, / ,J Residential: b~-''~~ ~
Prior Lake, MN 55 .~ 7Z.. Phone:/~7 ~7-~~73 Non-Residential: ~
A. BASEMENT ~s ~ N~f SUMP BASKET ~ 0~'T ~ 2 ~ 3 ~
WATER IN BASKET ~.~es ~ No SUMP PUM~ t~~ ~ 1 ~ 2~ ~ /3 '~~
WATER IN BASEMENT (flow over floor) ~ Yes l~~'o CISTERN ~ Yes I~.~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 ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspect' n:
When wa stem installed, or most recently modified? (Date)
Home came with system la Response to inspection program Q Other
~ W ' b ~ P t f'ld
and why
ater in asement rev s sys em ai e
i...-~"'
B. ROOF LEADERS: ~~~~ es ~ No DISCHARGE: a Near ay
C. YARD DRAINS ~ Yes t~'No WINDOW WELLS a Yes o
BEAVER SYSTEM l~ Yes o
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? a Fall Q Summer ~ Spr~ d Winter
(check all that apply) How often does pump run?
V~Fhere does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES:
SUMP PUMP SYSTEM: C~'ASS CI FAIL You have 30 days to bring your system into complianct with current
regu[ations. When you are ready for reinspection, ca11651 /644-1469 jor an appointn t!
Is there another place where clear water enters the sanitary sewer system? ~ Yes o
Where is this locati .
This area will nee to so the clear er~charges to the storm sewer system.
Resident:
Date:
Date:
. ~-
Disclairner: 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