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HomeMy WebLinkAboutSump Pump Inspection^, h-~~ ~:~ ~~~ ~~~.,~: t~ ~~ ~ City of Prior Lake Sump Pump and I/I Reduction ection Form ,~~,',,~,' ~ Name:~ ;~/~~~ ~Q~~/~~-~D Date~`~~ ~i~ Time/~L~~a.m./p.m. ,..~ p G. D /,/ ~~ ,,--, ~~ ` First Insp~ ion Second Q Address:,/'`~`~~Q (~/~~9.U~ ~~"/~Cl~r 0~= Own: ~' Rent: Age of Home:y3 ,,~ Residential: ~ N~=~ ~-, ,- /~/ Prior Lake, MN 55 ~ i~' Phone:'~!'Y~.S '~~ ~ Non-Residential: Q J y~ A. BASEMENT I~'Yes ~ No~ ~~ SUMP BASKET L~~~6~~ 1~ 2 ~ 3 ~ WATER IN BASKET Q Yes ~-~"0 5IJMP P ~'0 ~ ~1 ~~ ~ 3 Q WATER IN BASEMENT (flow over floor) ~ Yes ~ 3~~~STERN ~ e s ~ No (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 ~ Sanitary sewer ~ Outside O Floor drain ~ Other ~ .~-- Prior to Inspection: When system installed, or most recently modified? (Date) and why Home came with system Q Response to inspection program ~ Other O Water in basement ~ Prev' us system failed / B. BOOF LEADERS: ~~'~~ ~ es ~ No DISCHARGE: Q Near way C. YARD DRAINS ~ Yes Q~' N o WINDOW WELLS O Yes L~ N o BEAVER SYSTEM d Yes ~ D. PROPERTIES WITH SUMP PUMPS When does pump run? O Fall ~ Summer ~ Spring O Winter (check all that apply) How often does pump run? ''~ V~here does pump discharge to outside? l~ Front Q Back "[7 Side NOTES: SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance with curre regulations. When you are ready for reinspection, ca11651 /644-1469 for an ntment. Is there another place where clear water enters the sanitary sewer system? ~ Yes o Where is this location? This area will need to be~e~ the clea~at~~scharges to the storm sewer system. _ _ Inspector; ~ ' y~ - ``~----~'` Date: ,FG -'`~' ` ~ `~ Resident: ` ; ; , ~ ~ ' ~ Date: -~`-/~ ~ ~ Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections and does not imnlv the structure meets all Citv Codes. f t White: Homeowner Yellow: City Pinkc HRG