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;---..- -- ------- ----.. <br /> ✓ <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate Ihat a backwaler prevenlion dewce must be installed on the sevrer <br /> connection at the address identifi=d on ihe enclosed letter. Please help us verify thai our <br /> iniormation is correct by ansvering lhe follo�ving questions aboul your prop•:rty <br /> Do you have a basement? Yes [��No ❑ <br /> If yes, does it have plumbing fixtures (sink, �oilet, floor drain, etc.)? Yes [� No ❑ <br /> Do you have a backwaler valve on your sewer line9 Yes ❑ No ❑ Don't Knov� � <br /> Do you have a grinder pwnp in your basement7 Yes ❑ No �X( Don't Know �� <br /> Name: �19_�-�.��—-:�u��--_- <br /> Propertyaddress: _�.l��_�C���%v�_�_�vE/�'E// __ <br /> �'Phone 1: 70�5.��,,�_' yG `1�2. Phone 2: /��T <br /> ❑n;�d /_1��! _ --- --- <br /> i: - j r ��- � • � -�S' <br /> ,�, __ _ - ��,�, , }� ., _� �: a� ��� �.��E�z������� � � y . , ��� <br /> Cn LE _I�' ,i �!!.l'/l�i i;; , i �1�, �� . •�r+:�i! ..�� .n, • �n■ <br /> I <br />