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City of Prior Lake
Sump Pump and I/I Reduction
ion Form ~~~>>-
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Name:/~~~~~/~~~ h- ~ ~/ • Date: ~,ti~~ _Time~/8~~m./p.m.
j / ~,~J n ~-- First Ins ion Q Second ~
~ D
Address: ~'j`~So /~~~/O~' /E Q U.~(.~ - Own: Rent: Age of Home:~
~/,/ Residential: ~
Prior Lake, MN 55 ~~''~' Phone:'Y''Y ~~~o~~ Non-Residential: 17
A. BASEMENT C~''S~es ~ No~~- SUMP BASKET L~~~' ~ 1 L7 2 Q 3 Q
WATER IN BASKET ~ Yes L97Vo l SUMP P~`~~~~ L°I 0~ 1 L~ 2~~~~.~- ~
WATER IN BASEMENT (flow over floor) D Yes ~'~'No CISTERN d Yes C~'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 C~ Outside
at Inspection: ~ Floor drain ~ Other `
Prior to Inspection: ''
When was system installed, or most recently modified? (Date) and why
O Home came with system Q Response to inspection program ~ Other
B.
C.
D.
NOTES:
/ ~c../~ / O /~'~COO~ ~
~ Spring ~ Winter
~ Back Q Side
,ea ~
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an tntment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~~
Where is this location?
This area will'~need to be " ed the clear ate 'scharges to the storm sewer system.
Inspector: Date: /-.~ ~'
Resident: : , i-- __ Date: /- - __
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all City Codes.
O Water in basement I~ Previous system failed
ROOF LEADERS: ~ Yes L9''No DISCHARGE: ~ Near ~ Away
'
YARD DRAINS Q fi/fo ~ WINDOW WELLS ~
Yes tl~ Yes l4~
No
BEAVER SYSTEM O ~
Yes ~o
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall O Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? 17 Front
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