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� BACKWATER PREVEMT�ON DEVICE FINAL <br />INSTALLATION..CHECKL.IST <br />hndN�Gon Compmy Nzme and Cantact Inb: � <br />Dab Ba�dnqeer Pmvemi�n devka (BWD) rrea <br />u•"�i <br />YisteNatbn Properly Owner Name aM Contxt Ma: i G �xrj� S <br />PropMrAddRS9: Sil'7 �nrv'.w� f,r,Fa��� Q��OI <br />Pn.tnetMl�tlon hqp�,iion Cheddht <br />ADitema musf bs drecltM'Yes' in adar la e BWD fo be considered kx insfalfaBort <br />Is there a 6aeme.nt or bvel ot Ihe house Mwt b al or near essumed sewer main ebvation? (�, Yes ❑ No <br />Ne tl�e fnnues In t�e house bcate0 Delow IM upsbnm sewx nunhde rim elev�ion7 [�Yes ❑ No <br />k Iha side sewer ainAmly UNPROTECTED han seuar bxkups (does not hava a AYYU instatl�7 �'S'es ❑ No <br />Sib I�ellon CMcbbr <br />A9 �enx musf be d�erlrod'Yes' Aehre Mspedioe a ao�deredmnp�ete <br />Was ad� iarer 1V Im:xded hom buldinp W sewer maln4 �Yx ❑ No CaQibm: <br />Dae tlde se�w �ave �t least �Xe sbpe Gan IAe DuiO4ig to aewer main9 [�Yes D No o�.,�e: <br />Hwe�ee�u�er,�oa�mwosaeu�eee�araa.e�aixaacr �1r� ❑No <br />Nere M propeity � dralnage oonneabns b Ihe ske �ewer Deen IOaNiied end Ioated7 �Yes ❑ No <br />H�s WapoAr bwn evaluatcM lor dr�►'►a9e defio�nas wih Bnd'ngs oamwxwated m P►aOertS� ownef? � Yes ❑ No <br />NrovI1NOn Oenlb: <br />WNA lype ard brand oF BVYD was ir.s�ed at tl�b sik (fYean Ched� BNN. Gtinder <br />1Ylrote uras t» Aevke ir�alled (9e^erel Axoriplb^� altidf rruD)7 �Br�2$ <br />Was tline arry a0in serrer a slam drynage wak wmPbled in ca�jundion wAh Ihe BWD waKt Is so �easa des�e' — <br />InslNl�tlon CMtlilbt: <br />Are �I dowmpou6 ond slle drainage Eis�ronnulad han umstream d Ihe BWU? [y�(Yea ❑ No Comme�s: <br />Ooes BWDDosl6aiin7 meeh minimum sbPe m4ui�ar�x1 of �t%1 �Yes ❑ No Comments� <br />Can gWp pe qdNd out for �-,spe�tlon aiM maiMenanae elkr loosr��ag unmib sae�a7 (� res p No <br />u BWD bdce0 hb the p�opet poe�ion end Mum� saew eghtened'? �Yes ❑ W <br />CXde Ihe BYYD oover. irrlgaGon cvrar OandswDe aroa)1 tre�fe, 'Yl bearhg caver (c�lve suface) I aooess hakh {bu4din0) <br />Was prppoAy owner 51awn the�nffithe inq �d BWD? Yes ❑ No Commerds: <br />PropeAy OwnelE SignaW!e:✓� '`t'•�"� DaEe: <br />{rMallefs Sigrmlure: `' _ Dale� // -6 — .2A/y <br />Fevision:2 1 Frid�/, September 1t, 7014 <br />