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HomeMy WebLinkAboutSump Pump Inspection,:f~- .~ ci-- ~_~ ~ ~~, ,~,~ , ~` ~ City of Prior Lake Sump Pump and I/I Reduction Inspection Form ~ ;, ~,~- Name: ,..;~~ ~ r rv~ ~ ,~ ~ ,~;; ca bc~ ~~ Date: y- ,2 `l -9 ~ Time: JD~; 0 a.m./p.m. First Inspection L~ 5econd D Address: .,..~ 9~,~4 ~P ~ r u c~ ~ 1~'. ; V`J Own: ~ Rent: ~ Age of Home: ~~ Residential: C-1-' Prior Lake, MN 55 3 7~ Phone: ~/~/~' 1~~ ~ Non-Residential: ~ 1/lla~ t n u u'~' A. BASEMENT ~Yes ~ No 5IJMP BASKET Q 0 ~~ 2 O 3 O WATER IN BASKET O Yes L1'No 5iJMP PiTMP L~` 0~ 1 ~ 2 ~ 3 ~ WATER IN BASEMENT (flow over floor) ~ Yes L~'1~1o 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 Q Laundry tub at Inspection: ~ Floor drain ~ Sanitary sewer ~ Outside ~ Other ' Prior to Inspection: ~; When was system instaY~ed, or most recently modified? (Date) O Home came with system Q Response to inspection program ~ Other O Water in basement ~ Previous system failed and why B. ROOF LEADERS: Q' Yes O No DISCHARGE: ~ Near [7 Away C. YARD DRAIN5 ~ Yes l~" No WINDOW WELLS A'~Yes ~o BEAVER SYSTEM ~ Yes [~''No ~ l ~ ~r ~ ~ -~ D. PROPERTIES WITH SUMP PUMPS When does pump run? ~ Fall ~ Summer ~ Spring ~ Winter (check all that apply) How often does pump run? V~here does pump discharge to outside? ~ Front ~ Back ~ Side NOTES: SUMP PUMP SYSTEM: PASS O FAIL You have 30 days to bring your system into comp[iance with current regulations. When you are ready for reinspection, ca11651 /644-1469 for an appointment. Is there another place where clear water enters the sanitary sewer system? ~ Yes Q''~To Where is this location? This area will need to be fixed so the clear water discharges to the storm sewer system. Inspector: Date: ~/- ~ `/- 9 9 Resident: Date: ~/ - .2 `/ - 9 9 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 ~ .r.