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HomeMy WebLinkAboutSump Pump Inspectionry `.~~ ~~~ ~~ ~~ 1 City of Prior Lake Sump Pump and I/I Reduction Insnection Form ~~~)~ ~ ~ r~ Name:~~~G~.C- ~.~ ~/~Gtfi~'G"`~./C..~ Date:~7~~~~ Time~~ODa.m./p.m. j G,, f,~ ~ ! ~'~First In-sp~e '°n L~" Second ~ Address: /~~~~ ~~~ ~~~ ~~2 Own: L9' Rent: L7 Age of Home: ~ S !~~y~j, `/~9 Residential: ~ ~ Prior Lake, MN 55 e~ /N Phone"Y~Q~/ ~ Non-Residential: ~ / . _ .: I A. ~BASEMENT ~sfes ~ No~_~~ / SUMP BASKET ~ 1 ~ 2 ~ 3 ~ WATER IN BASKET ~ Yes ~No ' SUMP ~P~ 0 O 1 ~ 2~ ~~ Q WATER IN BASEMENT (flow over floor) ~ Yes L~'No CI5TERN ~ Yes @'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 17 Laundry tub ~ Sanitary sewer ~ Outside at Inspection: I~ 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 ~ Previ system failed B. ROOF LEADERS: E~No DISCHARGE: ~ Near L~'~Away C. YARD DRAINS ~ Yes ~~ WINDOW WELLS ~ Yes D"No BEAVER SYSTEM L~ Yes C~'NO D. PROPERTIES WITH SUMP PUMPS When does pump run? ~ Fall a Summer O Spring,~„_ ~ Winter (check all that apply) How often does pump run? ~- V~here does pump discharge to outside? Q Front ~ Back ~ Side NOTES: ,.•''~ SUMP PUMP SYSTEM: ~S I~ FAIL You have 30 days to bring your system into compliance with current regulations. When you are ready for reinspection, call 651 /644-1469 for an ap intment. Is there another place where clear water enters the sanitary sewer system? O Yes ~ No Where is this location? This area will need to b ed~se-I~'e clear ~r ~harges to the storm sewer system. Inspector: Resident: ~ Date: "T'-~' 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