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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
Name: ~~ r ~' , `~ i ~., d~ l~'I ; ~_ ~, ~ (~e
Address: l ~j ~~ ~ /(~a ~ ~ ~„i, Q ~ ~t7 /~/ ~
Prior Lake, MN 55 ? 7„Z Phone: ~' ~/ l~ - 6 6 7~/
Date: 7- 3_ 9~ Time: ~l~ oa.m./p.m.
First Inspection ~econd ~
Own: C~''`~R~ent: ~ Age of Home ~S.
Residential: 13'~
Non-Residential: ~
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A. BASEMENT es a No SiJMP BA5KET C~'~~~ 1~ 2 ~ 3 ~
WATER IN BASKET 17 Yes ~ No SLJMP PUMP ~''0 ~ 1 ~ 2 O 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes G3-~' CISTERN ~ Yes A-~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
at Inspection:
~ Laundry tub ~ Sanitary sewer 17 Outside
~ Floor drain Q Other
Prior to Inspection:
When was systern installed, or most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: C~''Yes ~ No DISCHARGE: ~ Near Ar-~Cway
C. YARD DRAINS ~ Yes ~''1Go WINDOW WELLS ~ Yes ~-~dr!"'
BEAVER SYSTEM ~ Yes o -
D.
NOTES:
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall O Summer I~ Spring ~ Winter
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front ~ Back O Side
SUMP PUMP SYSTEM: L~~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 appointment.
Is there another place where clear water enters the sanitary sewer system? O Yes Q--i~"
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: Date: ~. 3. 9 P
Resident: Date: '7- 3 - `~'J
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: Aomeowner Yellow: City Pink: HRG