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City of Prior Lake
Sump Pump and I/I Reduction
Inst~ection Form
Name: ~,--~ ~ 1/a CS'o ~ , ~ ~''~
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' Address: .3.,~ ~ ~/ o~~I ~ D S~-/
Prior Lake, MN 55 .3~.2 Phone:~J /
Date: ~ ~ - ~~ Time: ,S~iS a.m./p.m.
First Inspection C~~Second ~
Own: I~'"Rent: ~ Age of Home:~r,
Residential: L~-~-
Non-Residential: ~
~~,/n ( 4 U H ~T
A. BASEMENT ~~ No~~,,/'~ SiJMP BASKET ~ 0 1 O 2 ~ 3 la
WATER IN BASKET ~ Yes 13No SUMP PUMP ~~ 1 ~ 2 d 3 ~
WATER IN BASEMENT (flow over floor) ~ Yes La'1Q~o CISTERN ~ Yes L~Q"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 ~ Outside
at Inspection: ~ Floor drain d 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 Q Previous system failed
B. ROOF LEADERS: ~s ~ No DISCHARGE: Near ~ Away
C. YARD DRAINS ~ Yes L'~ No WINDOW WELLS ~ Yes 1~"No
BEAVER SYSTEM ~ Yes I~fo
D. PROPERTIES WITH SUMP PUMP5
When does pump run? ~ Fall ~ Summer ~ Spring ta Winter
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front O Back ~ Side
NOTES:
SUMP PUMP SYSTEM: ~PASS I~ FAIL You have 30 days to bring your system into comp[iance with current
regulations. When you are ready for reinspection, call 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C•YNo
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspect r: Date: ~-,,,~ ~ ~ 9
Resident: Date: 7- 3- 9~_
Disclaimer: This visual inspection is done with due diligence to f'md obvious clear water crass-connecNons
and does not imply the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG