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City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~~,~J-~
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Name:f .e~C~~~~~-%, 6.Jv~~" Date~'"~~ ~~ Time/lp~aa.m./p.m.
~/,(/GtJ00 ~/ ~,~ First In~_sp~e 'on ~cond ~
Address:'S`/~~ ~~~ ~~~ Own: ~'" Re`_nt~: Age of Home:~
,~~/y~~~ Residential:0~' ~
Prior Lal~e, MN 55 ~~~''~ Phone~~1~ :.~~~/J Non-Residential: ~
A. BASEMENT ~s ~ No~~~~ SUMP BASKET ~~ 1 ~ 2 Q 3 Q
WATER IN BASKET D Yes t~'No ~ 5UMP P~~ 0~ 1 ~ 2 ~~3' ~
WATER IN BASEMENT (flow over floor) ~ Yes L~No CIS1'ERN O Yes C-I'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 ~ Laundry tub ~ Sanitary sewer Q Outside
at Inspection: ~ Floar drain ~ Other ~
Prior to Inspection: r-~"'"
When was systern installed, or most recently modified? (D~te) and why
D Home came with system 17 Response to inspection program ~ Other
~ Water in basement O Pr 'ous system fail ed
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B. ROOF LEADER5
~ es ~ No
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~ DISCHARGE: ~ Near LL~Awa
y
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C. YARD DRAINS ~ Yes @
N~' WINDOW WELLS Q Yes C~No
BEAVER SYSTEM ~ ~
Yes mi1Vo
D.
NOTES:
PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall O Summer ~ Sp' ing
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back
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O Side
SUMP PUMP SYSTEM: ~ASS Q FAIL You have 30 days to bring your system into compliance w&h
regu[ations. When you are ready for reinspection, call 651/644-1469 for pointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to be f d,se~he clear w~ter,~scharges to the storm sewer system.
I Inspector: _/"~~ .~i'''7~ J~'~"`~,."''~ Date: ..~ "//- 9 j I
Resident:~.~, r, _ 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 Cit_y Codes.
~ Winter
White: Homeowner Yellow: City Pink: HRG