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HomeMy WebLinkAboutSump Pump Inspection~~ Q ~r ~ ~~ Insnection Form / ~~ Nam • ~~/~.~i(,~ I~~',~ ~~~ Date~7"~ ~ ~ Time! ~a.m./ .m. ~ ~ y ~ ~ I / ~ ~ ~ First In,s ~ec n~nd Q Address:~'`~~Q ~~j~ ~~`~~ Own: lT Rent: ~ Age of Home:~ ,~/ Residential: ~" ~ Prior Lake, MN 55 ~~.~ Phone- :7~7 ~.30~ Non-Residential: ~ A. ASEMENT es L7 SiJMP BASKET ~ 0 ~ 2 ~ 3 ~ ~~~ ~ ~ /~' WATER IN BASKET es ~ No SiJMP ~PU~M,.P-~- 0~ 1 ~ 2~~C~7 3~-~ WATER IN BASEMENT (flow over floor) ~ Yes ~o 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 ~ Outside at Inspection: D Floor drain ~ Other ~---'" Prior to Inspection: `'~ Whe as system installed, or most recently modified? (Date) and why Home came with system ~ Response to inspection program ~ Other ~ Water in basement O Previous system failed B. ROOF LEADERSc ~ Yes C~YN DISCHARGE: ~ Near ~ Away G YARD DRAINS ~ Yes ~ No WINDOW WELLS ~ Yes B''No BEAVER SYSTEM ~ Yes ~ D. PROPERTIES WITH SUMP PUMPS When does pump run? C] Fall ~ Summer (check all that apply) How often does pump run? V~here does pump discharge to outside? ~ Front NOTES: O Spring L7 Winter ~-'- ~ Back ~ Side ..-----•----~ =•-•-•---•---------•-•-•-•-•---•--- SUMP PUMP SYSTEM: t7`''~ASS Q FAIL You have 30 days to bring your system into compliance with current regulations. When you are ready for reinspection, call 651l644-1469 for art ap in3ment. Is there another place where clear water enters the sanitary sewer system? Q Yes L9~No Where is this location? This area will need to b i~ the clear ater~charges to the storm sewer system. r f __ Inspector: Resident: Date: ">'-//- 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. City of Prior Lake Sump Pump and I/I Reduction White: Homeowner Yellow: City Pink: HRG