2201 CEDAR ST 2022-04-13 - Laserfiche WebLink

. BACKWATER PREVENTION DEVICE FINAL INSTALLATION CHECKLIST Installadon Company Neme and Canlad Info: 7�ire �I� M�,�1v Dale Backuvater Preventlon device(BWD)was instatlep�/ -�� Da��tyis lo�m was oompleted: I 2'9- I `� Inslallation PropeRy 0wner Name and CanWcl inia/�aro n ��!� 1 /�a �h Property Address:_`12 0 I �(�a 1r S� -Z„r�,�� J� R P20 � Prcanatallnfon InspeeNon Cheekilst All Nems musf be checked'Yes'In oNer for a 6WD fo be consfdered lor JnsfaUaGon Is there a basement or level of ihe house thet is al or near assumed sewer main eleva6on7�Yes ❑No Are there fixtures in fhe house located below the upsVeam sewer manhole dm elevaUonT�Yes ❑No Is ihe sfde sewer currently UNPROTECTED Irom sewer badcups(does not have a BWD installed)?�Yes ❑No SRe M�peetlon Cl��cklict: All ifems must be ch,vcked'Ves'bePore inspection!s considered complefe Was side sewer N Inspeded from building to sewer main? �j Yes ❑No Condition: �e n 0 �oes side sewer have at least 196 alope irom fhe build'mg to sewer ma(n7 (�Yes ❑No Desaibe: Have ell building sewer drein wnnections to the cide sewer been Identified and loceted9 (�Yes ❑No Have ail property stoan drainage connections to ihe slde sewcr been Identified and localed7 �Yes ❑No Has properly been evalualed lor drainage defidenaes with findings communicaled to propeAy owne� �Yes ❑Na In�uilation D�hll�: What type and brend of BWD was Installed at ihis site(Gean ck BVW,Grinder pump,etc.):CLva✓ C{l�s c K Q�I�-- Where was lhe device installed(general desaiption,atte mep Was thero eny olher sewer or slorm dralnage work completed In conjuncdon with Ihe BWD work7 Is so pleasa desaibe:_ Inctdladon Checkif�t; Are ell dovmspouts end aite dra(nage disconnected from upsfream oi the BWD7 [�,Yes ❑No Commenls: Does BWD pos�ioning meets minimum slope requiremenl oi>196? �Yes ❑No Comments: C�n BWD be pulled oul for inspection end rt:�intenance afler loosening ihumb saew7 �Yes ❑No Is BIND laked Into the proper positlon and ihumb saew dghtened? j�Yr- ❑No Circle the BWD cover.irtigation caver(landscape area)1 treific load bea�ing coverldrive surface access hffi (bulid'mg) Was pioperfy oxmer shown tAe I tlon of lhe s 9 ❑Yes ❑No Commenls: Property 0umer's Signature: � Dale:,��- �- �y Installers Signature: ��—l',./v---� Uale: /Z— f- �f Revision:2 1 Tuesday,September 16,2014