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HomeMy WebLinkAboutSump Pump InspectiondF PRtp r~~ ~~ ~ % ~ ~ ~ ~ ~'~j, ~ ,~ ~`' City of Prior Lake Sump Pump and I/I Reduction ection Form ,~,~~J~ /~~/ /~ Name: ~J ~~~;~~/ ~~ ~ r Date~C~ ~~~ ~~ Time ~~~a. m. /p. m. Address:' Y~~ ~ ~ ~ O~, , ~ First In~spe~c ~' Second ~ Q ~ ~~p ~7 ~~ Own. tC~ Rent. Age of Home:~p `_,,~'' ~ r~ //~ ~,y Residential: @'' Prior Lake, MN 55~ /~ Phone~~"~'~'~g~/ Non-Residential: ~ A. BASEMENT ~~ No ~ SiJMP BASKE ~ 1 17 2~ 3 ~ WATER IN BASKET Q Yes o SUMP P 0 O 1 ~ 2 d~/i7 WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ Yes LzJ~ (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 ~ Other /'~ Prior to Inspection: ..~- When was system installed, or most recently modified? (Date) and why ~ Home came with system ~ Response to inspection program ~ Other ~ Water in basement ~ Previ system failed B. ROOF LEADERS: ~No DISCHARGE: ~ Near C~-~ Y C. YARD DRAINS ~ Yes ~~~ WINDOW WELLS es ~ No BEAVER SYSTEM 17 Yes [S' No D. PROPERTIE5 WITH SUMP PUMPS When does pump run? ~ Fall ~ Summer ~ S~rin,g ~ Winter (check all that apply) How often does pump run? Wrhere does pump discharge to outside? O Front ~ Back ~ Side NOTES: SUMP PUMP SYSTEM: I~PASS ~ FAIL You have 30 days to bring your system into coinpliance with curre . regulations. When you are ready for reinspection, ca![ 651/644-1469 jor an nhnent. Is there another place where clear water enters the sanitary sewer system? ~ Yes No Where is this location? This area will need to b ed the clear ater 'scharges to the storm sewer system. Inspector: Date: Resident: i Date: - ~ , Discl ' r: ' ual ' pection is done with due diligence to find obvious clear water cross-connections and does not imnlv t cture meets all Citv Codes. White: Homeowner Yellow: City Pink: HRG