HomeMy WebLinkAboutSump Pump Inspection
Tim~.m./p.m.
/ /r-f r" j....) f) J /. / First Inspe~ ttJ/S'econd 0
Address:/O / v I H/~)-IL..A)A/O fi V NIt.! Own: ~""'Rent: g....- Age of Home:Z'zLfJ D
1/7//; / I. L ~ /.;,../ Residential: ~ J
Prior?ke, MN 55v/;<./ Phoneo/.y~.yC67 Non-Residential: 0
A. /~<::esi!'~ A:~s DNa /' SUMPBASKET ~ 1 0 2 0 3 0
W A lER IN BA~KET LJ Yes ~o SUMP Pl.J!\W ~O LJ 1 LJ 2 LJJ-- LJ
WATER IN BASEMENT (flow over floor) 0 Yes (91i:io CISTERN 0 Yes eiio
City of Prior Lake
Sump Pump and III Reduction
Inspection Form lJ,lJpJj
)0,</6, 6~OJJQE Date:-I'199
....... -
Name:
(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
at Inspection:
LJ Laundry tub
LJ Floor drain
LJ Sanitary sewer
LJ Other -
LJ Outside
.....
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
LJ Home came with system
LJ Water in basement
LJ Response to inspection program LJ Other
LJ Pr~us system failed
~s LJ No. DISCHARGE: LJ Near ~y
LJ Yes ~~, WINDOW WELLS LJ Yes ~
LJ Yes ~o
B.
C.
ROOF LEADERS:
YARD DRAINS
BEAVER SYSTEM
D.
PROPERTIES WITH SUMP PUMPS
When does pump run? LJ Fall LJ Summer LJ Spring
(check all that apply) How often does pump run?
Where does pump discharge to outside? LJ Front LJ Back
LJ Winter
LJ Side
NOTES:
/'
SUMP PUMP SYSTEM: ~ASS LJ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection. call 651/644-1469 for ~ntment.
Is there another place where clear water enters the sanitary sewer system? 0 Yes ~o
Where is this location?
This area will need to ~. e~e clear ~te~harges to the storm sewer system.
Inspector: ~:t//ta-aT~./ Date: "Y-/- 9' 9
Residen..t.:.\.~ (;I--fKC' . v Date: ~ - / - ;; 9
, ~._~~
DiscIaUni: This vi~~ inspection is done with due diligence to fmd obvious clear water cross-connections
and doeS not imply. the structure meets all City Codes.
White: Homeowner
Yellow: City
Pink: HRG
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