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BACK��ATER.PREVENTION DEVICE PROGRAM <br />Our records indicate that a back�vater prevent�on device musl be instalied on the se�ver <br />conneclion at the address identified on Ihe enclosed lefler. Please help us verify that our <br />in(ormation is correct by ans�a�ering the following questions about your property: <br />Do you have a basement� Yes �] No ❑ <br />If yes, does il have plumbing tixtures (sink, toilet, (loor drain, etc.)? Yes ]� No � <br />Do you have a backwater valve on your sewer line? Yes No � x. Don't Know ❑ <br />• �, <br />Do you ha`ve a grinder pump in your hasemenl7 Y� ❑ No� Don't Kno�v ❑ I� j� <br />� <br />Name. <br />PropeRy address: ����'� <br />Phone 1:��5''�^.C.O• �� (1 <br />� — <br />r�n��i � 1����Ih[�.I/l►1(P_i�_�Od�' <br />c�'I I , <br />.. ��Arli� <br />,� 2 a . 3����-.. <br />�i � <br />�.1�.1�:�1,-, <br />,• . <br />,;.:'�t::ii:•�tti.•: <br />