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City of Prior Lake
Sump Pump and IiI Reduction
Inst~ection Form
Name: ~cr v~. c~ P~ , ~aS ~r ti w ~- ,~ c~rr~
Address: ~;~9 y D ~,m~,.~ v Ht- /V h/
Prior Lake, MN 55 ~7,~ Phone: ~17 •/~'~/
Date: 7- 3- Y~ Time: ` 0 a.m./p.m.
First Inspection ~ Second ~
Own: ~' Rent: ~ Age of Home: qy~;~.
Residential: C~- ~
Non-Residential: Q
C c~ r•,,/r/
A. BASEMENT es ~ No SUMP BASKET Q 0 ~~ 2 ~ 3 ~
WATER IN BASKET C~'P'es ~ No SUMP PUMP ~ 0 I~"f ~ 2 d 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes ~#o CISTERN O Yes ~'b
(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 Q Sanitary sewer ~side
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) ~ cc D and why
~ Home came with system ~ Response to inspection program ~''Other Z;..~ {,~ (/fr( ~./l~~N
~ Water in basement ~ Previous system failed ,6v f~-t G~ ~ µ-P,
B. ROOF LEADERS: ~ Yes ~J''No! DISCHARGE: d Near ~ Away
C. YARD DRAINS ~ Yes Cl'"'~o WINDOW WELi,S Q Yes ~Q"o"~
BEAVER SYSTEM 17 Yes ~No
D. PROPERTIES WITH 5UMP PUMPS
When does pump run? ~ Fall 13''S~ummer D~'S~pring ~ Winter
(check all that apply) How often does pump run? ~--~-~,/ ~y H-~y ,?Z a:.,5
V~here does pump discharge to outside? ~ Front O Back C3-~tSe '
NOTES:
SUMP PUMP SYSTEM: PASS ~ FAIL You have 30 days to bring your system into compliance 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 $"'1~0
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~~/( Date: '~ • .~ - ~ `1__ __
Resident: ~ ; , ,-. Date: 7- .? - y ~f
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