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HomeMy WebLinkAboutSump Pump Inspectionr` aF PRIp } ~,.~ -~ ~ ~ ~' ~ ~ ~ ,. City of Prior Lake Sump Pump and I/I Reduction Inspection Form ,~~,~'~ Name: ~~~ ~~.~~~~ ~..~~, ~~~~~Date:~ ~" ~ Time~~`~~a.m./p.m. ,,- ,~ !~/~ Op /J ~'~First In~sp~e~c ' l~ Second D /y Address: ~~ ,~ ~~ ~ ~ C.•~~ Own: L~J'" Rent: ~ ge of Home: /~ ,~y '/ Residential: ~ ~ Prior Lake, MN 55 ~/~~ Phone ~'~`~ ~~'~ ~ Non-Residential: ~ ,---- - A. BASEMENT es ~ No SiJMP BASKE ~ 0 1~ 2 ~ 3 ~ WATER IN BASKET a Yes o SUMP P Q 1 ~ 2_ O /3 ~~~ WATER IN BASEMENT (flow over floor) a Yes o CISTERN a Yes ~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 at Inspection: ~ ~ Laundry tub Floor drain ~ Sanitary sewer Q ~ Other ~ Outside Prior to I ction: "~ When s system installed, or mo st recently modi~ed? (Date) and why Home came with system L7 Response to inspecti on program O Other ~ Water in basement ~~ Prev' system fail B. ROOF LEADERS: L~~No ~ , ~ C. YARD DRAINS ~ Yes L9 ' N~~ ed DISCHARGE: O Near WINDOW WELi.S ~ wa y Yes No BEAVER SYSTEM ~ ~ , Yes [9~No 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 Q Spring ~ Winter ~ Back ~ Side NOTES: / SUMP PUMP SYSTEM: I~ASS ~ FAIL You have 30 days to brirtg your system into compliance with curr regulations. When you are ready for reinspection, cal! 651/644-1469 for an nt. Is there another place where clear water enters the sanitary sewer system? Ca Yes o Where is this location? This area will need to x~he clea~at~scharges to the storm sewer system. Inspector: • ~' ~ ""` Date: .,a - ~G - Resident: _ ~ ra tiA ~, v.c.- ~ 1 u -_ Date: -~.~- Disclaimer: This visual inspeetion 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