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HomeMy WebLinkAboutSump Pump Inspectiona~ F-~ ' ~ ,~ ~.~ P `~ ~ .. ~ ~ ., City of Prior Lake Sump Pump and I/I Reduction Inspection Form ,q,~,~~~ , ~,~/ ~j~ Name: /~/ /.~ tL/p//,O ~- Dat~"~'9~ Tim „~~~~a.m./p.m. , / o>,~/ ~(7 ~ '~-,~'~ ~ First Insp, ~ion Second D / Address: ~~NV~ U~~b~~;~S,Ei~:~ f,~ Own: ~' Rent: - Age of Home: C~ ~l ~! ,!,/ Residential: Prior Lake, MN 55 ~~N Phone?` ~`~~~ 1.,,~ Non-Residential: 17 ~~l~+C~~ ti' 'y ' A. BASEMENT es ~ SUMP BASKE ~ 0 ~ 2 O 3 ~ WATER IN BASKET es ~ No SUMP P 0 Q 1 ~ 2~ L~~ ~ WATER IN BASEMENT (flow over floor) C] Yes o CISTERN ~ Yes ~~ f 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 O Laundry tub ~ Sanitary sewer 17 Outside at Inspection: O Floor drain C7 Other ~" Prior to pection: -~''~~ Whe as system installed, or most recently modi~ed? (Date) and why Home came with system ~ Response to inspection program L] Other ~ Water in basement ~ Previous syst ailed B. ROOF LEADERSc O Yes DISCHARGE: ~ Near Q Away ' C. YARD DRAINS ~ Yes ~ V9~''' 1 WINDOW WELi,S ~ Yes [D..fiVo BEAVER SYSTEM ~ ~ 17 Yes ~No D. PROPERTTES WITH SUMP PUMPS When does pump run? Q Fall ~ Summer ~ Spyiug ~ Winter (check all that apply) How often does pump run? ~ Where does pump discharg e to outside? ~ Front ~ Back ~ Side NOTES: SUMP PUMP SYSTEM: Ldl PASS ^ FAIL You have 30 days to bring your system into compliance with current regularions. When you are ready for reinspection, ca[1651/644-1469 jor an appo nt. Is there another place where clear water enters the sanitary sewer system? ~ Yes ~L~"1Qo Where is this location? This area will need to ~'ixed~the clear,wate~,.d,ischarges to the storm sewer system. Inspector: `""""~ Date: ~i -'~-~`--'- 77 Resident: Date: - O ~- y , - 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. 0 White: Homeowner Yellow: City Pink: HRG