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HomeMy WebLinkAboutSump Pump Inspectionn ~'7 '~~ ~ ~~ ~ ~ City of Prior Lake Sump Pump and I/I Reduction Inspection Form ,~,~,~~-r Name:~~/~~•~~~~ ~ -C~~~ ~/~ Date~ ~'~,~ Tim~O~~a.m./p.m. // ~jO ~/~~ ~..~~ ~ ~ First Inspec ' ~cond ~ / ,. y Address: ~110 Own: Rent: Age of Home: ~~ ~~/ ~ /~ ~ „~ / Residential: Prior Lake, MN 55_ / Phone• ~~~ ~ Non-Residential: ~ A. BASEMENT es O N SiJMP BASKET ~ 0,,~~~ 2~ 3 ~ WATER IN BASKET s~ No SiJMP~~~ ~r a 1 O 2~ WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN Q 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 ~ Laundry tub O Sanitary sewer ~ Outside at Inspection: ~ Floor drain ~ Other Prior to Inspection: When w stem installed, or most recently modified? (Date) and why Home came with system ~ Response to inspection program ~ Other ~ Water in basement ~ Previous syste iled B. ROOF LEADERS: ~ Yes o DISCHARGE: ~ Near Q Awa C. YARD DRAIN5 ~ Yes ~~N ~ WINDOW WELLS s~ No BEAVER SYSTEM ~ Yes f~'No D. PROPERTIES WITH SUMP PUMPS When does pump run? ~ Fall d Summer ~ Spring t'7 Winter (check all that apply) How often does pump run? ~°---"~ Wihere does pump discharge to outside? ~ Front O Back ~ Side NOTES: SUMP PUMP SYSTEM: L~'~ASS ~ FAIL You have 30 days to bring your system into compliance with cur~ent regulations. When you are ready for reinspection, call 651 /644-1469 for an appoi . Is there another place where clear water enters the sanitary sewer system? ~ Yes o Where is this location? This area will need to be fi ~e clear~er d~' charges to the storm sewer system. ' Inspector: .~"'"" Date: ~ "-~' ~ 7 Resident: ~ _~ ~~ ~ ~~,,~°l Date: a , 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