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BACKWATER PREVENTION DEVICE PROGRAM <br />Our records indicate that a backwater prevention device must be installed on your <br />sewer connection to comply with the new ordinance. Please help us verify that our <br />information is correct by answering the following questions about your property: <br />Do you have a basement? Yes VNo ❑ <br />If yes; does it have plumbing fiktures (sink, toilet, floor drain, etc.)? Yes &�No ❑ <br />Do you have a backwater valve on your sewer line? Yes ❑ No [:],Don't Know <br />Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know R� <br />Properly address: C"0 1 b J A , Q i <br />Phone 1: .q Phone 2: . <br />Email: <br />