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City of Prior Lake
Sump Pump and I/I Reduction
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Ins~aection Form A ;, â~
Name: f U I T~? h~a ~'1. ~~' «h ~- ~ae ~ v~'- h
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Address: ~~/ ~ ~~ ~U~ r o~ ~'~ ~~
Prior Lake, MN 55~~~ Phone: L ~~/ D- 9!~ ~/
Date: - /P2- `~ Time: 96 ~ a.m./p.m.
First Inspection ~econd 17 /
Own: ~[3~" Rent: a Age of Home: C~
Residential: f~'~
Non-Residential: ~
,;.i~ / Et ~~U-~ _ _ _
A. BASEMENT ~'Yes ~ No 5iJMP BASKET ~ 0 Ca" 1~ 2 ~ 3 ~
WATER IN BASKET ~"Yes ~ No SUMP PUMP ~ 0 13~1 ~ 2 O 3 O
WATER IN BASEMENT (flow over floor) ~ Yes I~'No CISTERN O Yes O~'"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 la Sanitary sewer ~tside
at Inspection: I~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modified? (Date) ,.2 w~~~s ~d and why
,
~ Home came with system ~'"Kesponse to inspection ~rogram ~ Other
Q Water in basement t7 Previous system failed
B. ROOF LEADERS: ~''~es Q No DISCHARGE: a Near ~ay
C. YARD DRAINS ~ Yes I~''~o~ WINDOW WELLS Q Yes C~'1G~o
BEAVER SY5TEM Q Yes L~-'~o
D. PROPERTIES WITH SUMP PUMPS
Wh
? C7
d
l ~~=
'"
~
D
en
oes pump run Fal I3
ring
Summer Winter
(check all that apply) How often does pump run? /{ ~'{~.- ~~~G..y ~~,~',, f
V~here does pump discharg e to outside? O Front ~ck ' O Side
NOTES: - - - ⢠- - - - . . ._
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SUMP PUMP SYSTEM: ~ASS Q FAIL You have 30 days 1n bring your system into compliance with current
regulations. When you are ready for reinspection, call 651/644-1469 for an appoint~rra.
Is there another place where clear water enters the sanitary sewer system? [7 Yes f~1Vo
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
I Inspector: ~ ~; /~~ -- Date: /-/..2 i 9 9 I
Resident: ~ .~ ~Q ~~~ Date: ~ - /a? `7 `~
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes. ~~
White: Homeowner Yellow: City Pink: HRG