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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name: ~ nl(~ e~~ ~~/, 1~i ~ k ~ Date: ~-,z`/- y9 Time: S^~/va.m./p.m.
First Inspection L3~Second I~
Address: ~~ ~'~' /~ a S~. ..5~ Own: ~"` Rent: O Age of Home:~,
Residential: C~
Prior Lake, MN 55 j 7„2 Phone: L~// ~-.3 2?.3 Non-Residential: ~
V"G/ K~
A. BASEMENT es ~ No SUMP BASKET ~ 0 ~~ 2 ~ 3 ~
WATER IN BA5KET ~'Yes ~ No SUMP PUMP ~~ 1 17 2 Q 3 D
WA1'ER IN BASEMENT (flow over floor) O Yes A'No CISTERN 17 Yes ~1'Qo ~
(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 l~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was systern installed, ar most recently modified? (Date) and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Previous system failed
B. ROOF LEADERS: ~ Yes ~''~1o DISCHARGE: ~ Near O Away
C. YARD DRAINS Q Yes 13""~o WINDOW WELLS D Yes ~o
BEAVER SYSTEM 13 Yes D~o
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer O Spring ~ Winter
(check all that apply) How often does pump run? ~
V~here does pump discharge to outside? ~ Front O Back ~ Side
NOTES:
SUMP PUMP SYSTEM: L~'~ASS 17 FAIL You have 30 days to bring your system into compliance wuh current
regulations. When you are ready jor reinspection, call 6511644-1469 for an appointmera.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~-~iQo
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~ ,k Date: 6 - ~ `/- 9y
Resident: ~ s ~ -~-< ; 'c ~---r~- E~ ~ ~ i ; ` ~ ~: ~, ~ ~ ~;~ Date: f - ,? ~ / - 9~
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imuly the structure meets all City Codes.
White: Homeowner Yellow: City Pink: HRG