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HomeMy WebLinkAboutSump Pump Inspection~~ r ~,~'' ,~C% ~~ ~k:- ~~,~^f~' City of Prior Lake Sump Pump and I/I Reduction Insnection Form Name: ~~ ~.~ ~~~~~~r~~ ~~ Address: ~~~~~~~'~~~~~~ ~~ ~ ' ~~o -ro/~,~ Prior Lake, MN 55 ~/~ Phone: ,%~~P, ~" Date:~J `~~ ~~Time,!/~~a.m./p.m. First In~_sp~e ' n ~'" Second ~ Own: ~" Rent: ~ ge of Home: ~ Residential: ~ ~ Non-Residential: ~ A. BASEMENT ~LXe's ~,DT~' SUMP BASKET ~ 0~,,~'T ~ 2 ~ 3 ~ WATER IN BASKET I~es ~ No SiJMP ~P~ ~0 O 1 ~ 2 ~ 3 ~ WATER IN BASEMENT (flow over floor) ~ Yes I~'No CISTERN ~ Yes ~ (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 l~ Laundry tub ~ Sanitary sewer ~ Outside at Inspection: ~ Floor drain ~ Other /~- k B. C. D. Prior to Inspection: When wa tem installed, or most recently modified? (Date) and why ome came with system ~ Response to inspection program O Other ~ Water in basement ~ Prev' s system failed ROOF LEADERS: ~~ es No DISCHARGE: ~ Near L9''Away ~~ ~~.~ YARD DRAINS~~~r~v es WINDOW WELLS ~ Yes L~'"No BEAVER SYST~EM~~~ ~ ~ ~ Yes o A PROPERTIES WITH SUMP PUMPS When does pump run? 17 Fall ~ Summer ~ Spring (check all that apply) How often does pump run? ---'~ Where does pump discharge to outside? ~ Front Q Back ~ Side NOTE5: SUMP PUMP SYSTEM: 19'PASS ~ FAIL You have 30 days to bring your system into compliance with current regulations. When you are ready for reinspection, ca11651/644-1469 for an app ' era. Is there another place where clear water enters the sanitary sewer system? ~ Yes o Where is this location? This area will need to b~~e clear v~nter~charges to the storm sewer system. _ ( Inspector: ~ ~u~"" ~-~''' Date: .:~ - ~v ' 77 I Resident: ~ , .,,,.~ ,, Date: Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections and does not impl_y the structure meets all City Codes. White: Homeowner Yellow: City ~ Winter Pink: HRG yyy~~~ ~ ~ ~ . . . . ... ~ i i _..~ ~~ 4... ~ '~.l ~ ~ . ~~ `-~ (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 a Outside at Inspection: Q 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 ~ Previous system failed B. ROOF LEADERS: ~ Yes~ No DISCHARGE: ~ Near ~ Away C. YARD DRAIN5 ~ Yes ~ No WINDOW WELLS ~ Yes ~ No BEAVER SYSTEM 17 Yes ~]' No D. PROPERTIES WITH SUMP PUMPS When does pump run? ~ Fall ~ Summer L~ Spring Q Winter (check all that apply) How often does pump run? V~here does pump discharge to outside? ~ Front ~ Back ~ Side _ r'_'_'_'_'_'_' '_'3,~_'_'_'_'_'_'_'_'_ NOTES: ~HL~. l~/ 1~ 1~~SOtJE,----/S 'l^f~~ N@~ iE '--~ASSEt~ t 1 T7 ~ o~.,~~~~ QO i'c~' / S /4- ~~DT~ -' ~LE~IsaG C't~~eRE"c-r- //~~ S'ys7F_ ^~ SUMP PUMP SYSTEM: ~ PASS t~ FAIL You have 30 days to bring your system irtto compliance with current regulations. When you are ready Jor reinspection, cal[ 651 /644-1469 for an appointment. Is there another place where clear water enters the sanitary sewer system? ~ Yes ~ No Where is this locaf ? This area will ed Xo be fi}ged so the clear water dis~r~,es to the storm sewer system. I Inspector: Date: 7-p(.~"'y' ~ I Resident: 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. White: Homeowner Yellow: City Pink: HRG A. BASEMENT ~ Yes ~ No SUMP BASKET 0~ 1 L7 2~ 3 ~ WATER IN BASKET ~ Yes ~ No SUM~iJMP 0~ 1 ~~~ 3~ WATER IN BASEMENT (flow over floor) ~ Yes o CIS ERN ~ Yes No