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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
Name: .S~AY l h ~A,. ~r''S'"
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Address: S~s`~ ~~"~ ~~ S ~
Prior Lake, MN 553 ? z- Phone:y4~i- ~`l~s~
Date:~~ ~ 3~g9 Time: //.'/S~/p.m.
First Inspection ~Second ~
Own: ~ Rent: ~ Age of Home:
Residential: ~
Non-Residential: ~
A. BASEMENT ~Yes C] No SUMP BAS T IJ'b ~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~'1Q~o SUMP P P I~''6 Q 1 ~ 2~~~~ O
WATER IN BASEMENT (flow over floor) d Yes o CI5TERN ~ Yes I a' N 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 ~ Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
~ Home came with system
CI Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program ~ Other
~ Previous system failed
L~'~es L~ No DISCHARGE: Q Near ~way
~ Yes YY~7' No WINDOW WELi.S ~ Yes L~''~io
~ Yes
D. PROPERTIES WITH 5UMP 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? Q Front ~ Back Q Side
NOTES: ---•- - - •-•-• -
SUMP PUMP SYSTEM: ~PASS O FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready for reinspection, ca[[ 651 /644-1469 for an appoi-ttment.
Is there another place where clear water enters the sanitary sewer system? l~ Yes A~No
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector:
Resident:
Date: 2- 2. 3- 99
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 Citv Codes.
White: Homeowner Yellow: City Pink: HRG