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Name:
City of Prior Lake
Sump Pump and I/I Reduction
Inspection Form ,~;~,~J ;1'
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GC~C//~,U~.~~ ~ ~~~ Date:~ ~ 7 Timej ~~Q.m./p.m.
~'', /~~ ~ ~f~ ~~D~ ~~ ~~- First In_spe~ct,l'~~ L~''" Second a ~ Q
Address: ~;J'y ~~ Own: ~'" Rent: ~ ge of Home. ~~ /~/
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D. PROPERTIES WITH SUMP PUMPS
When does pump run? O Fall a Summer ~ Spring.__- O Winter
(check all that apply) How often does pump run? ~---
Where does pump discharge to outside? ~ Front ~ Back ~ Side
`1 ~. ~ /~~Q~~ ~Residential: '
Prior L ke, MN 55~/ ~i~ Phone'~~~ Non-Residential: ~
A. ASEMENT es ~ No~~ SiJMP BASKET ~ 1 ~ 2 a 3 ~
WATER IN BASKET ~ Yes CU~No ' SiJMP P ~ 0 O 1 ~ 2 a 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes ~~~1o CISTERN O Yes ~-?d'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 ~,~...- O Outside
at Inspection: O Floor drain I~ Other
Prior to Inspection: /''
When was system installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Prev' s system failed
B. ROOF LEADERS: es ~ No DISCHARGE: ~ Near ~
C. YARD DRAINS ~ Yes ~' N WINDOW WELLS ~ Yes ~'1Qo
BEAVER SYSTEM ~ Yes L'~'1 0~~
NOTES:
SUMP PUMP SYSTEM: ~'"fPASS ~ FAIL You have 30 days to bring your system into compliance with current
regu[ations. When you are ready j'or reinspection, call 651 /644-1469 for an ent.
Is there another place where clear water enters the sanitary sewer system? ~ Yes No
Where is this location?
This area will need to ixe e clear w r d~rges to the stortn sewer system.
Inspector`/~- ~~`'~`~ Date: 4~ -'`7'' I7
Resident: ~ : .;~ ~~,~~ ; ~ Date: .~ - y R
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