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• 1 . .. . .. , . . . . <br /> . �. _ . .. y� . . <br /> � � ��� <br /> -,,`� BACKWAT[F2 PREVENTION�D�;JICE PROGRAM <br /> . ��,, . <br /> Our mcords indicate tnat a backwater prevent��n device musl be installed on your <br /> se'�ver connection to comply u-'ti Bie nai��ordmance. Please help us veri(y that ow <br /> info,r�ation is correct by answering the following queslions about your property`. <br /> , Do you have a basemen[? Yes `�� No ❑ <br /> If yes, does it have plumbing fxtures (sink, toile!, floor drain, etc )? Yes�7J No ❑ <br /> Do you hai�e a bar.kwate�valve on your sewer line? Yes ❑ No� Oon't Know�-- `�� <br /> Do you have a grinder pump in yo� basement? Yes ❑ No �'Don'i Kno�v ❑ ._.. A .�� <br /> �V <br /> �Name��r �CZ/"� c� <br /> ! / <br /> Property address _.�����,/�����I/ ''� <br /> Phone 1: !. �_�/ z Phone 2: <br /> Email �4� ��- '� ) � ' ' ' ' ��. � <br /> p�� � . .. .,.�. 17;�' !�'N-+I7 •• ,• { ^ <br /> ���1 �1� :�lii._f�t��e_n1�.ill�:t'fll�--�i�`��'� ,��.�!�•^_.ii_�Ell'i:i.11l:e.�: � <br /> ----- � - - - -_ I <br /> � <br />