HomeMy WebLinkAboutSump Pump Inspection~F PRIp
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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
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Name: ~~ ~ /~ ~„) ~.C/ ~ .
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Address:L~~G'~~ /`~r~~,~l~'c/Q /~/.(~~
Prior Lake, MN 55~ ~i~J Phone:'~`~7~~' r~
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Dat~%'~~~~ Time:/~~a.m./p.m.
First Inspec 'on ~~Second ~
Own: ~ent: ~ ._Age of Home: ~~
Residential: ~ .~
Non-Residential: ~
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A. BASEMENT ~s ~ SUMP BASKET d ~ 1~ 2 ~ 3 d
WATER IN BASKET es ~ No 5iJMP P~~ 0~ 1 ~ 2 ~O ~3-~
WATER IN BASEMENT (flow over floor) ~ Yes L~i'No 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 O Sanitary sewer ~.,...0 Outside
at Inspection: a Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
O'''~ome came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previou system faiied
B. ROOF LEADERS: l~'Yes Q No DISCHARGE: ~ Near L~"Away
C. YARD DRAINS ~ Yes ~/N/o '~ WINDOW WELi.5 ~ Yes B-No
BEAVER SYSTEM ~ Yes L~QO
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring Q Winter
(check all that apply) How often does pump run? '"'~
V~here does pump discharge to outside? ~ Front ~ Bacly.- Q Side
NOTES:
SUMP PUMP SYSTEM: f~'~'ASS ~ FAIL You have 30 d8ys to bring your system into compliance with current
regulatioru. When you are ready for reinspection, cal[ 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~~Vo
Where is this location?
This area will need to ix~the clea~at~}ischarges to the storm sewer system.
Inspector:
Resident:
Date: .~ %G -3 -
Date: ~
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not unnlv the structure meets all Citv Codes.
White: Homeowner Yellow: City '~ Pink: HRG
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