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City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: _~j/~ic~ '~~, r.~ Date: ~~/- f~ Time: : v a.m./p.m.
~ First Inspection L~""Second ~
Address: ~~~ f~~r:~'~; ,~, S"~. ...; ~ Own: L~---Rent: L'~ Age of Home:~~
~~ ~ _ r`,~-p ~ Residential: C-1~--
Prior Lake, MN 55 ,~ %Z Phone:;~ Non-Residential: ~
~JU ~~i/ O N
A. BASEMENT es ~ No SUMP BASKET D 0 ~~ 2 D 3 L7
WATER IN BASKET ~"'`i'es ~ No SUMP PUMP ~ 0 [3''f ~ 2 ~ 3 D
WATER IN BASEMENT (flow over floor) Q Yes ~~'IG"o CI5TERN ~ Yes C3~s
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. Skip to Part S of this form.)
Discharge Point ~ Laundry tub ~ Sanitary sewer ~ ide
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was system installed, or rnost recently modified? (Date) and why
Q'~ Home came with system la Response to inspection program ~ Other
Q Water in basement l7 Previous system failed
B. ROOF LEADERS: 17 Yes ~'140 ~ DISCHARGE: C~ Near ~ Away
C. YARD DRAINS ~I Yes [~No WINDOW WELLS Q Yes 1~-^i~S
BEAVER 3YSTEM I~ Yes ~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~] Summer Q Spring Q Winter
(check all that apply) How often does pump run? C'y'~ r~ /~ ~~, ~ 1.
V~here does purnp discharge to outside? ~ Front Q ack L~--,&~la~
NOTES:
SUMP PUMP SYSTEM: C~3"YASS ^ FAIL You have 30 days to bririg your system into compliance with current
regulations. When you are ready for reinspection, ca![ 651/644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes ~To
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: 1,.J ~?^'( ~ Date: ~-~~' 9 9 I
Resident: , ~,~ , ~ ~ Date: ~ - ~ 1- cj~
Disclaimer: This vi.sual inspection is done with due diligence to find obvious clear water cross-connections
and does not imnlv the structure meets all Citv Codes.
White: Homeowner :Yellow: City Pink: HRG