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, . . . j <br />BACKWATER PREVENTION DEVIGE PROGRAM <br />.. �,,-:�,; - <br />Our records indica�e that a back�vater prev2ntion device muSt he installed on th� sewer <br />�onnection at the address identified on the enclosed letter. Please help us verify lhal our <br />intormation is correct by answering the following questions aboul your property: <br />Do you have a basement? Yes �(J No ❑ �nlasH�+' <br />,. ���,,,[[[ <br />If yes, does it have plumbing fixtures (sink, toilet, fioor drain, etc )7 Yes g,J N� <br />/' <br />Do you I�ave a back�valer valve on your sewer line? Yes ❑ No ❑ Don't Know� <br />Do you have e grinder pump in your basemer.t? Yes ❑ No ❑ Don't Kno�v �] <br />—j'� p �� <br />Name: ��1 �1a�� I-- <br />Propertyaddress ��1� �_%�a�'� ��Uv' "`�+'�"1 OZ�3 <br />Phone 1: �i� 0� ;J.�3__ Phone 2: .� ��=l V��(L� <br />Email: a 1 q• T�I'�(h� a lo�/ C{V►'1L1.1 �-�` Wi <br />�.�•,u �.;r�;t.L. <br />