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HomeMy WebLinkAboutSump Pump Inspection,~ ~ ~~ PRIp ~J .~ 4. ~~~~ ~ ~ City of Prior Lake Sump Pump and I/I Reduction Inspection Form ,q,~~ ~ Name:~ ~'/ /~~ ~J f~.~ T Date~ ~~r/ Time~ODGa.m./p.m. ~~Q y - ~.~~,,,First Insp,e~ on ~'""Second ~ Address: ~~~'~~ ~O/.C ~ ."~ Own: ~ Rent: Age of Home:~~J ,/'/ Residential: ~ . Prior Lake, MN 55 ~~~ Phone'Y'Y~;Zi2.3 `JJ Non-Residential: ~ ~ .--- - - -- .,.- ~.-- . A. BA5EMENT es a No~~ SUMP BASKE 1~ 2 ~ 3 ~ WATER IN BASKET ~ Yes ~No SiTMP P 0 Q 1 ~ 2~ ~~ ~ WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes C9-2Go (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: O Floor drain Q Other -~''~ Prior to Inspection: -~""~ ~ When was system installed, or most recently modified? (Date) and why ~; D Home came with system ~ Response to inspection program ~ Other ~ Water in basement O Previous syst failed B. ROOF LEADER5: ~ Yes ~ DISCHARGE: Q Near C] Away C. YARD DRAINS ~ Yes L~!' ~N~ WINDOW WELLS Q Yes ~~to BEAVER SYSTEM ~ Yes Sa''No D. PROPERTIES WITH SUMP PUMPS 'f When does pump run? ~ Fall Q Summer ~ Spring ~ Winter (check all that apply) How often does pump run? ~ V~here does pump discharge to outside? ~ Front ~ Back Q Side NOTES: / SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance with current regutations. When yoa are ready jor reinspection, ca11657/644-1469 jor an ent. Is there another place where clear water enters the sanitary sewer system? ~ Yes o Where is this location? This area will need to be edls~'.#tie clear ~ter~~harges to the storm sewer system. . Inspector: Date: ~ ~ >~ - Date: /6- 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