2429 CEDAR ST 2022-04-13 - Laserfiche WebLink

BACKWATER PREVENTION DEVICE FINAL INSTALLATION CHECKLIST Insfallation Company Name and Contacl Info:M oP��Kr��7��+/ �-(� S 7G� � 3 G u Date Bar.invater Prevention device(BWD) was installed, I-�S-� f Date lhis torm was compleled: � - IS-/ S Inslallation Prnperfy Om�ner IJame and Contacl Inlo: L4 c_C./ F�� I I�./ P�operty Address: a �(� �"( (�-,/ � - -- Pre-InsWllation InspecGon Checklist: Alf ifems must 6e Checked'Yes'in ader(a a BV✓D to be considered(nr ins�allahon Is there a basement or level oi the house that is at or near assumed sewer main elevation? 5�S]Yes ❑ No Are there fixtures in Ihe house lotated belo.v Ihe upslream sewer manhole rim etevalion?�Yes ❑No Is lhe side setti�er currzntly UNPROTECTED from sewer backups(does not have a 8WD installed)7 �Yes �] tJo Site Inspectfon Checklist: All items musf be checked'Yes'belore inspection is considered complete l'das side seNer N inspecied from building to se.ver main? L'j Yes ❑ No Condi'ion: D�es side sewer have al least 1%slop2 from lhe building to sewer main? (�Yes [��o Describe:__ _ __ _ Have 211 building sewer drain connechons b the side sewer been identi(ied and located? Q Yes ❑No H.ve atl property srorm drainage connections to the side sewer been itlentifed and localed9 1�']Yes ❑ No Has property been evalualed for drainage deficiencies��ith findinos communicated lo property owner? Q Yes ❑ No Installation Oetails: What type and brand ot OVJD was inslalled at Ihis site(Clean Check BWV, Grinder pump, etc.)� C�.n�� Where was the device installed(yeneral description,�ttach map)� _ i�� 3� �t wr�,.,�' n � �� / >.� _ c,� L a." L��.�- �Ei�% �Iuo� c�.rc,;n Wa; there any other sewer or storm drainage work completed in conjunctmn wilh ihe pWD work?Is so please desr,rihe _ Installalion Checklist: Are all downspouts and site drainage d�sconnected from upslream oi lhe BWD? (�1'es ❑ No Commenls: Does BWD positioning meets minimum slope requirement ol>1%? �P]Yes ❑No Comments: _ Can BWD be pulled oul for inspection and maintenance afler loosening ihumb screw? �fZ Yes ❑ No Is BWD locked into the proper position and Ihumb screw tightened7 �X(Yes ❑ No Circle the BWD cover. irrigation cover(landscape area)/iraifc load bearing cover(drive suriace) access uilding) lNas property owner shown lhe location of ihe inslailed BN'D? �Yes ❑No Commenis Properiy Owner's Signature: _ Date: _. Inslallers Signature: �V � � "`- Date: I — I S -� S Hevision 2 1 Monday,September 15, 2014