2812 LEONARD DR 2022-04-29 - Laserfiche WebLink

� BACKWATER PREVENTION DEVICE FINAL IN�TALLATION CHECKLIST Installation Company Name and Conlacl ln(o: �l �G��/ ��w�l3i +�,- 3� 7—�So 7 � Date 6ack�vater Prevenlion device (BWD) �vas installed 2/ ��/� f Dale this form was comp!eted: 2/S/i� Installation Properly Owner Name and Contact Iniu: �fivaa ��5l� r ProperiyAddre;s:,35�L L �onoio !�2 - Pre•Inslallation Inspection Checklist: All items must be checked'Yes' in order (or a BWD to be considered (or installafion Is there a basement or levei of the house fhat is at or near assumed sewer main elevalion? [�'i'es ❑ No Are fhere 5xtures in the house located beloe� the upsiream sewer manhole rim elevalion?y] Yes ❑ No Is the side sewer wrrenllyUNPROTECTEO from sewer backups (does nol have a BWD installed)7 � i Yes ❑ No Site Inspection Checklist: All ifems must be checked `Yes' be(ore inspecfion is considered complete Was s�de se:ver TV inspecled from building lo sewer main? �'Yes ❑ No Condition: Does side sewer have at least t% slope from fhe building lo see�er main? �,Wes ❑ No Describe: Have all building sevrer Jrain connections to Ihe side sewer been identified and localed? �'Yes ❑ No Have all property slerm drainage connections to lhe side sewer been identifed and located? �rj] Yes ❑ No Has properly been evaluated ior drainage defciencies �vilh f ndings communicaled to property o�vner7 (� Yes ❑ No Installatian Details: What type and trand ot BWD �vas inslalled al ihis sit ean-Check BNN, Gri e� pump, elc.)� �Vhere was Ihe device installed (general description,�Ch�nap�'? ;,,�� De � F �,o��r, , �, Was there any other se�ver or storm drainage �vork compleled in conjunclion wilh the BWD �vork? Is so please describe: _ Installation Checklist: Are zll do�.vnspouls and site drainage disconnecled (rom upstream o( Ihe BWD7 �Ye: Daes BWD po�itioning meels minimum slape requirement of >1%?� Yes ❑ No ❑ No Commenls: Comments: Can BW� be pulled ou� for inspeclion and maintenance aHer loosening lhumb screw? (��Yes ❑ No Is B1ND locked inlo ihe proper posifion and (humb screw tighlened7 �Yes ❑ No Circle lhe DWD cQver. ' igalion cover (landsc�e.� tra(fic load bearing cover (drive surtace) I access halch (building) Was prope�ly owner sho�vn ihe location of the instailed BWD? �l'es ❑ No Commenis: Properfy 0wner's 5ignature'.��liJ^�7 �j,��L� ,i� �,� Date: 2/s/i � / '�--- Z /S /i f �� Datc: Ins�alers SignafuGe � Revision: 2 � Friday, September 12, 201A