2022 HOYT AVE 2022-04-19 - Laserfiche WebLink

; BACKWATER PREVCNTIGN DEVICE FINAL ; INS'�ALLATION ChECKLIST � � � Irstall-:lion Company Name ar,d Contacl Info:��.�1�1�1 G�I�SC� �i�''�L �: � Date 6ackv�ater Pre��enticn clzvi ce(BVVDj��as installed:��_l�,�__D2�e this form t,�as wmpleletl:�— _C� l !nst211ation Property 0�•mer Name and C ntac.-t In(o: Lc�1� Ff--U��e�- PropertyAddress: ��' �l�` �l\'� ___ Pre•installatioii Inspection Checkiist: �1!rtems rnust be checked'Yos'in order icr a Bl^!D to be considered(or instalfafion ' 's Ihere a basemenl cr Lvel o(the nouse that is at or near assumed se�ver main e�ee2'ion?1,��Yes !] No Are there f,dures in lhe hous�located belo�v the upstreaR�sewer marhole rim elevation? �Yes ❑ No Is the side sev:ar currently U�dPROTECTED(rcro sewer bae�ups(does not have a 8!ND instailed�? ��Yes ❑ P�o � Site Inspection Checklist AI!i;�ms miist be checked'Yes'befora inspection is consrd?red complefe � :':'s�side sev:er N msoec!ed irom buiiding�o seeJer main? �Yes ❑ No Condition: _ Does side se�:er have at leasf 1%slb,^,e from the building to se��er main7 �Yes ❑ No Describe: __._____ Have all buildirg se��rer drain co:�n�clions t�the side .e�,ver been identified and lacatetl? �Yes ❑ No � Have all properry stom�drainage connectians to the side sevrer been identified and located7 �Yes ❑No ' Has property been evaluated for drainage deficiencies wilh findings communicated lo propedy ot^ner? �Yes ❑ No ' Installation�etails: �— ��- � � 1';'hal type and�rand o(8l'JD was ins!alled ct this sile Clean Check 4W, GVrinder p�w77��ppi, etc.): 1` � � _X-�� . � 1';'rere�vas the device installed(neneral descrip6on,a -ca map)� �<<L-1� �j0�`�'. ��iL��_ �s , � � I VJas there any other sevrer nr s'orm drainage�vork compLted in corjunclinn��n�h th'e BVVD erork? Is so please descr'.be:�U � � Installation Checklist: � Arc all downspouts and site drainayc disconnected from upstrear,of Ifie 8�,1'D? �]Y'es I_� No Cnmmentt: Does BWC positioning meets minimum slope require nen!of>1%,? � Yes []No Comments:________ � Can BV�'D be pulled oul for inspection and maintenance a(ter toosenino Ihumb sr.re�v? �J Yes [}No ' Is BWD locked inio!hc proper posi(ion and Ihumb screw Gghtened? ; 1,Ycs [ � �'n i Gi;cie the BIN�cover. irrigation co��r andscape area d lra(fic load bearing cover(drive sur�ace)I access hatch (building) � 1':�as properly ov;ner shotivn the location o the installed B:'JD? f";�Yes ❑No Commenis:_ ��. � � Property Ov;ner's Signa ure: Date: �� 1�J'�I� I Inslalters Signature: \ �_ �ate:. 1-.' �_��1 'l � Revisnn: ? _ 'e'�undal', SeGte'nLrr I5, 20'_•5 �