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HomeMy WebLinkAboutSump Pump Inspection~ ~~ ~ ~ City of Prior Lake Sump Pump and I/I Reduction Insnection Form Name: (~.o '~/~! ,~,~f/.S.,C"= Date:~° J' ~ ~ Timer'/~a.m./p.m. ~~~ ~~~~~ ~~ ~~ First Ins ec ~ lJ----S~ond ~ ~ _P~..~ Address: ~ L•~ ~G Own: @'' Rent: ~ Age of Home:~~ , ,. / Residential: ~~-~'"~ ~ Prior Lake, MN 55 ~~~' Phone: ~~~ °~~~~ Non-Residential: ~ A. BASEMENT O Yes ~ / SiJMP BASKET E~-?'"0~ 1~ 2 ~ 3 ~ WATER IN BASKET ~ Yes ~IQo SiIMP P~~ ~'0 Q 1 ~ 2~ Q ~3 -~ WATER IN BASEMENT (flow over floor) ~ Yes L~#'No CISTERN ~ Yes L~~o (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: When was system installed, or most recently modified? (Date) ~ Home ca~ne with system ~ Response to inspection program ~ Water in basement ~ Previou system failed B. ROOF L~A~.DERS: C. YARD DRAINS BEAVER SYSTEM and why ~ Other Y~ es o DISCHARGE: ~ Near ~-'l~way es ~ No~,~-~' WINDOW WELLS ~ Yes ~ I~ Yes ~ D. PROPERTIES WITH SUMP PUMPS When does pump run? ~ Fall ~ Summer (check all that apply) How often does pump run? V~here does pump discharge to outside? ~ Front NOTES: ~ Spr~ ~ Winter ~ Back--~ ~ Side ..-•-•-•-•-•------------- - - -r~-•-•-•-•-•-•-•- SUMP PUMP SYSTEM: I~ASS ~ FAIL Ypu have 30 days to bring your system into compliance with cunent regulations. When you are ready for reinspection, call 651/644-1469 for an appointment. Is there another place where clear water enters the sanitary sewer system? ~ Yes ~''No Where is this location? This area will need fi~ce~o the cl r y~r discharges to the storm sewer system. Resident: ~ Date: Date: '1 ~. A/ ~ ~f '1 Disclaimer: This`visual inspection is done ~h due diligence to find obvious clear water cross-connections and does not im 1 the structure meets all Cit Codes. White: Homeowner Yellow: City Pink: HRG