HomeMy WebLinkAboutSump Pump InspectionCity of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
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Name: GC,~G~`.~,~~ ~,1 e.~~t.-~ Da~~~ `~Timel~~` ~a.m./p.m.
~y~~J - ~~ First In~spe~c ' n ~econd Q r~r/
Address: ~~ / I l/V~Q,D~C-/-3LVnJ G/~G Own: L~3''f Rent: ~ Age of Home;N /
Prior
~/~/ Residential: ~ ~
MN 55~~~/`~ Phon~`~~"~'~0 Non-Residential: ~
~Ww.c. ~e:~ ,~
A. BASEMENT es ~ No / SiJMP BASKET 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~(,Pd'o SiTMP 1P~ 0~ 1 ~ 2L ~~' ~
WATER IN BASEMENT (flow over floor) ~ Yes ~ftO CISTERN ~ Yes Q'NO
(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 sewe ~ ~ Outside
at Inspection: ~ Floor drain ~ Other
r
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system
O Water in basement
B. ROOF LEADERS:
C. `YARD DRAINS
BEAVER SYSTEM
O Response to inspection program D Other
O Pre ' us system failed
l'~ Yes ~ No DISCHARGE: ~ Near way
~ Yes ~~~ WINDOW WELLS ~ Yes ~
~ Yes Pd' No
D. PROPERTIES WITH 5UMP PUMPS
Wl~n does pump run? 17 Fall ~ Summer ~ Spring ~ Winter
(check all that apply) How often does pump run? ^
V~here does pump discharge to outside? ~ Front ~ Bar,l~- ~ Side
NOTES:
SUMP PUMP SYSTEM: L~PASS ~ FAIL You have 30 days to bring your system into comp[iance with current
regutations. When you are ready for reinspection, cal[ 651/644-1469,for an ap o ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~~'~
Where is this location?
This area will need to e e clear ate~5charges to the storm sewer system.
Inspector;
Resident:
Date: ~ -zS-
Date: _ - Z~-'
I Disclaimer: Th~visual inspection i"s done with due diligence to find obvious clear water cross-connections I
and does not implv the structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG