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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Forrn
Name: ~~r~ ~~r~h , ~c~~ ~/~ Date:~_ Zy_ p~/ Time:~3l.S~a.m./p.m.
First Inspection t~`~rSecond ~
Address: ~, ~,~`U ~; i~G.,,.~, ~I, ry ir„~ ~~ ,;F Own: ~"'"- Rent: ~ Age of Home:?
Residential: i~''"
Prior Lake, MN 55 37~ Phone: yf1-,1,5"cP`~'` Non-Residential: ~
„~~t~rUh
A. BASEMENT C3-~e`s ~ No 5UMP BASKET f~'6~ ~ 1 ~ 2 Q 3 ~
WATER IN BASKET ~ Yes Q No 5UMF PUMP C3°'6~ ~ 1 ~ 2 ~ 3 ~
WATER IN BASEMENT (flow over floor) O Yes, ~-Pk~ CISTERN Q Yes C~'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 17 Sanitary sewer ~ Outside
at Inspection: 17 Floor drain ~ Other
Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why ~;
l~ Home came with system O Response to inspection program ~ Other
~ ~ Water in basement ~ Previous system failed
B. ROOF LEADERS: Q Yes L~'No DISCHARGE: Q Near ~ Away
G YARD DRAINS d Yes C~~ WINDOW WELLS ~ Yes a No
BEAVER SYSTEM ~ Yes L~IQo~
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 I~ Back O Side
NOTES:
SUMP PUMP SYSTEM: @'I'ASS ~ FAIL You have 30 days to bring your system into compliance with current
reguladons. When you are ready jor reinspection, ca[1651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~'o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: L/ ~'~"'~°~' Date: ~- 1`/- y7
Resident: r~ Date: 7- ~`/ - 99
~
Disclaimer; This ~vi~al inspection is done with due diligence to find obvious clear water cross-connections
and does not imn~v he structure meets all Citv Codes.
White: Homeowner Yellow: City Pink: HRG