Laserfiche WebLink
instailation Compa <br />Dale 8ackwaler Pr <br />Installation Propert <br />Praperty Address: <br />. BACKWATER PREVENTION DEVICE FINAL <br />INSTALLATION CHECKLIST <br />,�►�r� can ��:� � G�r s� c1� ��, L LG <br />Pre•Instailation Inspection Checklist: <br />Afl rtems musf be checked 'Yes' in order tor a BVVD to be considered fcr irstallation <br />Is ihere a hasement or level of the housc that is al or near assumed se�ver main elevation? (�'Yes ❑ P!o <br />Are there fxtures in the house Iccated helow the upstream sewer manhole rim elevation? [�es ❑ No <br />Is ihe side se�ver currently UNPROTECTED from sewer backups (does not have a 8WD instalied)? �es ❑ No <br />Site Inspection Checklist: <br />Nlf ifems musf be checked'Yes' 6etore inspecfion is consrdered complete <br />�Nas side sev�er TV inspected from building to se���er main? pi'Yes ❑ No Condition: �_� T <br />i <br />Does side seveer have at least 1% slope from the building to se�ver main? [�'es ❑ No Gescribe� <br />Have all building se�ver drain connections to the side see+er been idenlified and located? (�s ❑ No <br />Have all properly storm drainage conneclions to the side sev;er been itlentified and located7 �es ❑ No <br />Has property been evaluated for tlrainage deficiencies with findings communicated to property owner? [�Yes ❑ No <br />/ <br />Installation Details: r <br />What type xnd brand of BWD was installed at this sile (Clean Check BWV, Gnnder pump, etc.): ��' �/� � <br />Where �vas the device installed (general description, attach map)? � N �}.�i72'C' c� f� � r{-fd.� <br />Was ihere any other sewer or sterm dr �nage work completed in conjunclion with the BWDIw^or_k? I^s so pie se describq: __ <br />_ �1LCCs�-� �-� i.� � _: �u,X'2_��—�r �Q1�.�_ � C <br />installation Checklist: <br />Are ail dovmspouls and sile drainagc disconnected from upstream oi the BWD? (�Yes ❑ No Comments: <br />Does AWD positioning meets minimum slope requirement o( >1 °!o? [j�'es ❑ No Comments: ___ , <br />Can BWD be pulled oui for inspec6on antl maintenance afler loosening lhumb screw? j�Yes ❑ No <br />Is BUVD locked inlo lhe ro �[_er,position and thumh screw tightened? ,[�Yes U No <br />Gircle the BWD cov���o.a���nd3cape area) / Iraffic toad bearing cover (drive surface) I access hatr,h (buildin9l <br />Was property owner sho�vn Ihe loca�ion oi ihe installed BWD? �'Yes ❑ �o <br />Property Owner's Signature: � <br />Inslaller's Signalure: � <br />Commen�s: <br />Date: q � 17 / �S <br />Dale: Q ��� <br />Reviiion� 2 1 Friday, September 12, 2014 <br />