1302 COLBY AVE 2022-04-13 - Laserfiche WebLink

BACK�'VATi ER PREVENTI6N DEVICE FINAL E� fNSTA�LATION CHECKLIST Ins'allalion Company Name and Contact Info: �1L""k��?�O�H 11��L1�.� �6 • ��Gs• y�� Cate Backwat?r Prevention device(BVJD)vras �ns;a'led: -20� 1 Date lhis form was cornpieled �'�/-2o/S I�staliation Property Ovr�er Name antl Contar.i Ir`o:lr u�e �-�3�Nz�rw �u'� �� •3a�� ProNerty Address: ��1 r�1�7`/ A�� Pre•I�stallation Inspection Checklist: F.I!items must be checked 'Yes'in order for a BVJD to 6e considered for installation '; tl�zre a basement or lavel o(lhe house tF�al is at or near assumed setiver main elevalion? Yes ❑ tvo HrF there fixtures in the house located belo�v the upstream sev+er manhole rim elevalion? Yes ❑No , Is the s de se�cer currenUy UNPROTECTED irom s��aer backups (does not have a�IND inslalled)?IL}�Yes ❑ No � Site Inspection Checklist: All items musf be checked 'Yes'before inspection is considered complete 1'Jas side sev;er N inspected from building to sev:er main? �Yes ❑ ho Condition: '� Does side se�ver have at least 190 slope from trie buildirsg t6 s2wer main? �Yes ❑No� fDescribe: H2ve ail building se�ver drain connections to the side se�„er been identified and IoCated? [J Ye ❑ No Have all�Sro perty stonn drainage connections lo the side se�ver been identified and located? �Yes ❑�lo ' Has properiy heen evaluated for drainage de(iciencies vrith f�ndings ccmmuniCated to prooerly owner? �1'es ❑ No Installation Details: ��pR�iil I l�dhat lype and brand of BIND��as installed at this sit Clean C VdV,Grind r pump, etc.): i I Vuherc ti•aas the d�vice nst�Iled (general descripiion, attach map)? _� ��St�t� �- X C _N�t� R�%�c ' � Fd:,s there any other sev+er or storm drainage�rork completed in conjunclion with ihe BWD�+�ork?Is so please describe l�(� Installation Checklist �iie:�II dovrnspouts and site drainage disconnected from upstream of th BWD? �Yes ❑No Comments, � Does �VJD positioning meets minimum slope requirement of>1%? aYes ❑ No C¢mments: Can BWD�e pulted out for inspection and maintenance alter loosening t wmb screw? G Yes ❑No II Is BIND locked inlo the proper posilion and thumb screvr t�ghtened? �Yes ❑No Circle the BWD cover irriqation cnver pandscape area trzffic loa bearing cover(dnve su�face)/access hatch(building� --�--�_- 1Vas properly owner sho�r+n the location of the installE�BWD? Yes ❑ No Comments: .--' ...--r' ��._� � _ ic_.... �! ' Dale: I ' � �' ��7 Property Ov;ner's Signature: � Date: � ��, ��' am�� Ir.stall�r's Signature:�4 I��t^ �Q�r.Q � I u � Revis�on 2 1 Monday,September 15,2014 ,