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HomeMy WebLinkAboutSump Pump InspectionOF PRIp ~~~ ~~ ~ ~~ U ~ City of Prior Lake Sump Pump and I/I Reduction Inspection Form ,q~,~ ~~- ~ ~ `--~~ Name: ~~~ /O~ ~Jc.~'~~ Date~ `~`~ Time~~~ Qa.m./p.m. // ,~/ First In~s~p~ec ' Second ~ Address: /100~~ ~~ ~~~~~00~0 ~.~ Own: @'" Rent: Ca Age of Home: ~ , ,~J .,,.~Residential: ~' Prior Lake, MN 55 ~~~ Phone:7`~0%^~~~ Non-Residential: D A. BASEMENT f~es a No ~ SUMP BASKET ~(y~l ~ 2 O 3 ~ WATER IN BASKET ~ Yes o SUMP~~~~ ~0 ~ 1 ~ 2~ O WATER IN BASEMENT (flow over floor) ~ Yes o CISTERN ~ 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 I~ Laundry tub Q Sanitary sewer Q Outside at Inspection: ~ Floor drain ~ Other ~'''~~ Prior to Ins ction: When systern installed, or most recently modified? (Date) '"~ and why Home came with system ~ Respo e to inspection program ~ Other O Water in basement ~ Pre ' us system failed B. ROOF LEADER5: Yes DISCHARGE: ~ Near way C. YARD DRAINS es o WINDOW WELi.S ~ Yes ~ BEAVER SYSTEM I~ Yes ~ D. PROPERTIES WITH SUMP PUMPS When does pump run? Q Fall 17 Summer (check all that apply) How often does pump run? V~here does pump discharge to outside? ~ Front NOTES: ,~~• c ~9/// -•-•~-~ ~- -• 1 ~ • f---' ~-~I ~ ~' u ~ Spring ~ Winter ~ Ca Back d Side ~ •---•~-•-•-~.A 4 L / s ,c~ ~ . . . SUMP PUMP SYSTEM: SS ~ FAIL You have 30 days to bring your system into compliance with curre regu[ations. When you are ready jor reinspection, ca11651 /644-1469 for an ap ent. Is there another place where clear water enters the sanitary sewer system? Q Yes o Where is this location? This area will need to b ed~e clear w~ dis arges to the storm sewer system. Inspector: • -''L'~`~" Date: ...:3- ~ - ~y Resident: Date: - 6 - I Disclaimer:61`his visual inspection is done with due diligence to find obvious clear water cross-connections I and does not imuly the structure meets all Cit_y Codes. White: Homeowner Yellow: City Pink: HRG