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City of Prior Lake
Sump Pump and I/I Reduction
ection Form
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Name: ~,: ,~;,-, ;Q a s ~~ ~ ,,,~~. r~
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Date: -- ~ ~ ~~ `1~ Time: ~1'~ a.m./p.m.
First Inspection C~' Second ~
Address: ~.`. .~,~ ~ ~~ ~f ~ ~~~ ~;; Pd ~ i~ S~~ ~ ~~ ~--~ Own: f~'~ Rent: ~ Age of Home:~
Residential: ~"
Prior Lake, MN 55 ; 7 Phone: ~~/ 7- 3'~? ~a 7 Non-Residential: ~
;.,.~ ~ % ~, ~, ~ -t- ~
A. BASEMENT C-~'~es ~ No 5UMP BASKET ~ Q" 1~ 2 ~ 3 ~
WATER IN BA5KET I~ Yes 13'~1o SUMP PUMP 0~ 1 ~ 2 O 3 ~
WATER IN BASEMENT (flow over floor) a Yes C~-No CISTERN ~ Yes I~~do
(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 Q Laundry tub Q Sanitary sewer D Outside
at Inspection: Q Floor drain ~ Other
Prior to Inspection:
When was system installed, or most recently modi~ed? (Date) and why
~ Home came with system ~ Response to inspection program Q Other
~ Water in basement Q Previous system failed
B. ROOF LEADERS: C~'''Yes O No DI5CHARGE: ~ Near A'~~way
C. YARD DRAIN5 O' Yes ~~1o WINDOW WELLS ~ Yes ~'1~io
BEAVER SYSTEM ~ Yes ~No
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
~ Spring ~ Winter
~ Back Q Side
SUMP PUMF S'3~STEM: I~~ASS ~ FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready jor reinspection, ca[[ 651/644-1469,/'or an appantment.
Is there another place where clear water enters the sanitary sevuser system? Q Yes L~''1~0
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
Inspector: ~.--afi Date: ~/- Z 3- 7 9
Resident: Date: ~/ - .~ ~ - y' ~
Disclaimer: This "visu~l inspection is done with due diligence to find obvious clear water cross-conneMions I
and does not imply the structure meets all Cit_y Codes.
White: Homeowner
Yelbwic'; City
Pink: HRG