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City of Prior Lake
Sump Pump and I/I Reduction
Insnection Form
Name: ~' ;~~rs-Y 1, ~~ c, ~ v Date: ~~-~' f rj~ Time: f; ~/a a.m./p.m.
~/ First Inspection ~ Second ~
Address: /~~~~ `/ 1 ~ yti,/~ ,. ~~ur~ ~(,' ~/ Own: C'1""" Rent: Q Age of Home: ) 9
Residential: ~3''
Prior Lake, MN 55 3~,~ Phone: ~~ -? `,r` Non-Residential: ~
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A. BASEMENT L~''~es ~ No SIJMP BASKET ~''6 Ca 1~ 2 ~ 3 ~ ~
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WATER IN BASKET Q Yes ~ No SUMP PIJMP ~~ 1 ~ 2 ~ 3 ~ ,~ .
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WATER IN BA5EMENT (flow over floor) I~ Yes Cf1Q"o CISTERN ~ Yes ~"No
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(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.) '~`
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Discharge Point ~ Laundry tub ~ Sanitary sewer ~ Outside ~,~ ; ,x. ~
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at Inspection: Q Floor drain ~ Other .
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Prior to Inspection: y, ,.. .
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When was system installed, or most recently modified? (Date) and why
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~ Home came with system ~ Response to inspection program ~ Other ,~;~
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a Water in basement ~ Previous system failed
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B ROOF LEADERS: Q Yes 13'~No DISCHARGE: ~ Near ~ Awa
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C. YARD DRAINS a Yes L~''I+1o WINDOW WELLS ~ Yes C-~'1'Qo
BEAVER SYSTEM ~ Yes ~''No
D.
NOTES:
PROPERTIES WITH SUMP PUMPS
When does pump run? Q Fall ~] Summer
(check all that apply) How often does pump run?
Where does pump discharge to outside? ~ Front
~ Back ~ Side
SUMP PUMP SYSTEM: ~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When ynu are ready for reinspection, ca11651/644-1469 jor an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C'1'r~ o
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
I Inspector: ~ -:~` Date: ,~ - ? /- ~,~_ I
Resident: Date: S=~/~ y y
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Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
[7 Spring ~ Winter
White: Homea.wner` ' Yellow: City Pink: HRG