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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? YesX No ❑ <br /> If yes,does it have plumbing fixtures(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 �Z/'�5`have <br /> 2agrinder pump in your basement? Yes ❑ No� ❑ Don't Know <br /> i..�r <br /> Name: - `r^ir'1 �v�ir� v <br /> Property address: P 2 (VCR <br /> Phone 1: '&0-4-19-(cS2^W Phone 2: ko-7t5S- <br /> Email: •Sk Q, -.?- 5V--NG ` CAir-‘ <br /> yy x u <br />