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City of Prior Lake
Sump Pump and I/I Reduction
Insuection Form
Name:
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Address: f L! ~~ 9~(~~ ~~'T~~ ~D 1(/E
Prior Lake, MN 55 '~ 7~ Phone:
Date: 7/- 9~ Time: / 7.3 o a.m./p.m.
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First Inspection ~econd ~
Own: L~''Rent: ~ Age of Home: ~ I'
Residential: I~'
Non-Residential: ~
~,~,/'N ~N O H'~
A. BASEMENT ~s ~ No SI7MP BA5KET ~~ 1 ~ 2 ~ 3 ~
WATER IN BASKET ~ Yes ~ No SiJMP PUMP ~ Q 1 ~ 2 17 3 Q
WATER IN BASEMENT (flow over floor) ~ Yes l~3Qo CI5TERN ~ Yes A~To
(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 Ca Sanitary sewer Q Outside
at Inspection: ~ Floor drain Ca Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) and why
, Q Home came with system ~ Response to inspecti on program ~ Other
~ Water in basement ~ Previous system failed
' B. ROOF LEADERS: ~s ~ No DISCHARGE: ~ Near A~way
C. YARD DRAINS ~ Yes L~''~1o WINDOW WELLS ~ Yes ~~
BEAVER SYSTEM ~ Yes ~'1Qo
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer 17 Spring ~ Winter
(check all that apply) 1y~ How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back ~ Side
NOTES: ~S•c~~.~,<< 1S.-•~n-,.p~"'1/, ,~~~~..~~,c~~----GH-----,r.s~~~~ a., --~~~4f1~-•-
~f~c~ ~~.t / ~~,w~ . ~~/~,~° (l~ ~y~~r ,.~~/2 - ~6~'- `7 7 tl^'~C~
SUMP PUMP SYSTEM: 17~ASS O FAIL You have 30 days to bring your system into compliance with current
regulalions. When you are ready for reinspection, ca116511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes A"T~o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: Date: ~~ /- 9j~
Resident: 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 City Codes.
White: Homeowner Yellow: City Pink: HRG