HomeMy WebLinkAboutSump Pump Inspection ProgramCity of Prior Lake
Sump Pump and I/I Reduction
Inspection Form
,
Name: f~'C~~~~-!~ ~~~ Date: /~ J Time~~~~'a.m./p.m.
~ ? p ~~'
7~~~~' ~~~Q ~~/~ l,~ /,~ First Inspec ° ~econd ~ ~
Address: Own: Rent: ~ Age of Home:
,~/ ~T~~6 Residential: ~
Prior ~,ake, MN 55 ~~~ Phone: r~ ~ Non-Residential: ~
, ~,,,~,,,~~ ~ ~... ~c...- -- ,
A. BASEMENT es ~ SUMP BASKET 0 ~ 2 ~ 3 ~
WATER IN BASKET es ~ No SiTMP P 0~ 1 Q 2~ ~~~
WATER IN BA5EMENT (flow over floor) ~ Yes o CISTERN ~ Yes Q~IQo
(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 I~ Laundry tub C] Sanitary sewer ~ Outside
at Inspection: ~ Floor drain Q Other ~
B.
C.
D.
NOTES:
Prior to I ection:
When s system installed, or most recently modi~ed? (Date)_
Home came with system ~ Response o inspection program
~ Other
and why
Q Water in basement ~ Prev' s system failed
ROOF LEADERS: es Q No DISCHARGE: ~ Near L'~~Away
YARD DRAINS ~ Yes ~~ WINDOW WELLS Q Yes E3~'Na
BEAVER SYSTEM ~ Yes ~#~~10
PROPERTIES WITH SUMP PUMPS
When does pump run? 17 Fall ~ Summer
(check all that apply) How often does pump run? _
V~here does pump discharge to outside? ~ Front
~ Spring
- Q Winter
------
~ Back ~ Side
SUMP PUMP SYSTEM: L4''PASS d FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, ca[[ 651 /644-1469 for an appoi t.
Is there another place where clear water enters the sanitary sewer system? Q Yes o
Where is this location?
This area will need to so the clear ter~harges to the storm sewer system.
,
Inspector:
Resident:
Date: y ' ~ -
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 Pink: HRG