HomeMy WebLinkAboutSump Pump Inspection,,~7 ~,-.~ _
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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: ~~ G,/~ y~ ~_~
;~~.~~7 ~ ~ ~ ST S ~
Address: /L G p ) ~~9~
Prior Lake, MN SS~~~ Phone:
Date: ~j Time: ~' a. ./p.m.
First Ins ection~
Own: Rent: ~
Resi en ial:'~
Non-Residential: ~
Second ~ ~o u
Age of Home ~d
. ~-~ - ~
A. BASEMENT Yes ~ No 5UMP BASKET ~ 0~ 1~ 2 ~ 3 a
WATER IN BA KET ~ Yes ~No ' S PUMP ~ 0 ~ 1 Q 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes No CISTERN ~ Yes 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 sewer C7 Outside
at Inspection: ~ Floor drain Q Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system L~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~ No DISCHARGE: Q Near Away
C. YARD DRAINS Q Yes No WINDOW WELLS Yes~No
BEAVER SYSTEM ~ Yes No ~ ~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring I~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back 17 Side
NOTES:
SUMP PUMP SYSTEM
_...,r...,..,..
Resident:
Date:
Date:
Disclaimer: This visual inspection is done with due dilige~ce to t"lnd obvious clear water cross-connections
and does not imply the structure meets all City Codes.
,. , . .
d
~ FAIL You have 30 days to bring your system into compliance with current
regutations. When you are ready for reinspection, ca[l 651 /644-1469 for an appointment.
White: Homeowner Yellow: City Pink: HRG
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~No
Where is this 1 on?
This area ' ne~d o 1~'fj 'ixed so the clear water sc rges to the storm sewer system.