Laserfiche WebLink
I <br /> BACKWATER PREVENTION DEVICE FINAL ' <br /> �- INSTALLATION CHECKUST ; <br /> � <br /> i <br /> � <br /> ; <br /> ��-f- �br`� � <br /> Installafion Company Name and Contact Info: I <br /> Date Bsckwaler Prevention deviee(BWD)vras installed: L �� 1� Dale this form was comp!eted: � � �S � <br /> InstallalionProperty0wnerNameandContaclin(o: 1go�-��Zi� ��a��'n�"^ �Lri����- ��o-�v«�^ j <br /> i <br /> PropertyAddress: ���� C�>�hu ��'C i <br /> Pre•Installation Inspection Checklist: ! <br /> Alf ifems must be checked'Yes'in order(or a 8WD to be considered forirstai;at'on ; <br /> is there a basemenl or level of fhe house lhat is at or near assumed sewer main elevationl[�Yes ❑No � <br /> Are ihere fix�ures In the house located beloe�Uie upstream sewer manhole rim elevation?(p Yes ❑No i <br /> Is the side sewer currenUy UNPROTECTED from seerer backups(does not have a 8WD Instailed)1 u Yes ❑No � <br /> i <br /> Site Inspection Cheeklist: � <br /> AII ifems must 6e checked'Yes'hefore inspection is considered complete ! <br /> Was side sewer N inspecied from building to sewer main? �Yes ❑�o Condition: � <br /> Does side sea�er have at least 1%slope(rom the building to sewer mafn? [�Yes ❑No Describe: � <br /> t <br /> Have all building sewer drain connec�ons to the side sev+er heen identified and located? [�Yes ❑No ( <br /> Have alI propetty storm drainage connections to the side se�ver been Identified and locatedll �Yes ❑No ; <br /> Has property been evaluated for drainage deficiencies v+ilh findings communicated to property owner7 �]Yes ❑No ; <br /> I <br /> !nstallation Details: � <br /> What type and brand of B��VD�vas installed at lhis site Clean Check BNN, rinder pump,etc.}: i <br /> Where vras the device instalied(general description,attach n�. . ''^^ ' '��t`� o� �a C��-�f �r�Q ' <br /> _ <br /> ' „�1� '� '-1 -F 1 �, .... b �i 1�i' � ' <br /> INas lhere any other sew'�er or slorm dra age wor completed in conjunction wilh Ihe B1ND vaork?Is so please describe:_ 1 <br /> y� � �C1�1-C�{� n �� C GA 1,eG� n�rnt�✓1 r(�it.uh - � <br /> � � <br /> Installation Checklist: i <br /> Are all dovanspouts and sile drainage disconnecled from upsiream of the[3WD? Qf Yes ❑ No Comments: i <br /> Does BWD positioning meets minimum slope requiremenl 0(>1%? [�Yes ❑No Comments: � <br /> Can BWD be pulled out for inspeclion and maintenance after loosening lhumb screw? m Yes ❑i�n ; <br /> Is BWD locked Into the proper positi Ad thnmbscrew tightened? �]Yes ❑ No ; <br /> Circle the BWD cover:�rti9ation cover(landscape are�l UaKc load bearing cover(drive surfar.�)1 acce�s hatch @uilding) ! <br /> VJas property owner shovm the focation of Uie insta6td BWD? �Yes ❑ No Comments: j <br /> � <br /> Property O�mer's Signature: Oate: ( <br /> Installers Slgnature Date: y �-� � � <br /> �.—_-_.; <br /> � � <br /> Revision:2 1 Friday,Sepcember 12,2014 <br />