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HomeMy WebLinkAboutSump Pump Inspection~o~ ;v~ ~ x _ ~ ~ City of ~Prior Lake Sump Pump and I/I Reduction Inspection Form , 'i ~~. ~- ~~: / ~' ' ~~- ~m Name: ~~~~~ ~C._~~~ , ~ Dat~-:-~"~=~-' ~ ~~ Time~~7~.m./p.m. ,(~ ~/ ,~/ t First In~s e~c ion I~''Second ~ Address: ~ 7~ 1~~''~~'`'~'~'~f`~ ~~l~' Own: L~'" Rent: I~. Age of Home:~~ ~~y ` ~, /~ ~;/~ Residential: L'~7~~ ~ Prior Lake, MN 55 ~-- 0~' Phone: ~` ~ Non-Residential: Q f Z„ v~~t~ rc.. /~ A. BASEMENT es ~~~~ SIJMP BASKET d 0 1 d 2 ~ 3 ~ WATER IN BASKET C9~Yes ~ No SUMP P~ 0~ 1 Q 2~ ,~O-~ ~ WATER IN BASEMENT (flow over floor) ~ Yes ~fi1o CISTERN ~ Yes 1~ 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 ~ Outside at Inspection: ~ Floor drain ~ Other ~~ ~,--- Prior to Inspection: Whe as system installed, or most recently modi~ed? (Date) and why Home came with system C7 Response to inspection program ~ Other ~ Water in basement a Prev' us system failed B. ROOF LEADERS 1~", ~~' Yes ~ No DISCHARGE: a Near way ~~ ~ ~/ C. YARD DRAINS ~ Q Yes L~~ ~N WINDOW WELLS ~ Yes e'"No BEAVER SYSTEM ~ Yes ~'No D. PROPERTIES WITH SUMP PUMP5 When does pump run? ~ Fall ~ Summer (check all that apply) How often does pump run? V~here does pump discharge to outside? L~ Front NOTES: ~ ~ Spring ~ Winter ..~- ~ Back I~ Side ~- SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into comp[iance with current reguladons. When you are ready for reinspection, ca[l 651/644-1469 for an ap ointmera. Is there another place where clear water enters the sanitary sewer system? ~ Yes L~No Where is this location? This area will need to b e e clear w e~ischarges to the storm sewer system. Inspector: ' ;%~~`'~ `" ~--- Date: _~ Resident: ~ ,~~ ~ r~,~.,~ ~ 0 i Date: .S- 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