1226 MAPLE ST 2022-05-02 - Laserfiche WebLink

� BACKWATER PREVENTION DEVICE FINAL � INSTALLATION CHECKLIST /� n � � / Inslallalion Comoany Name and Conlact in(o: C� 1 n> 17��C1ri/ LL� Date backwaier device(BWD)was inslalled: '�—/�� Dale this for�was completed — Inslallalion Property Owner Name and Conlacl Inio: _ � "��« �I � Praperty Addiess: Pre•Installation Inspection Checklist: All ilems must be cher,ked'Yes'in order for a B WD to Le considered for installatiai Is there a basement �r level of ihe house lhal is at or near assumed sev�er main elevation?�Yes ❑No Are there fixlures in Ihe house located below the upstream se�ver manhole rim elevation7�Yes ❑No Is Ihe side sewer currenUy UNPROTECTED irom sev�er backups(does not have a BWD installed)? [�Yes ❑No Sile Inspeclion Checklist: ��,� ��c 22�2g �''1 � All i�erns must 6^checked'Yes'6e(ore inspection is considered complete � Was side sewer TV inspected from building to sewer main? �Yes ❑No Condilion: n)- � �� Does side sewer have al least 1%slope from lhe building to sewer main? �Yes ❑ No Descri6e: Have all building sev�er drain conneclions fo Ihe side se�.ver been identified and located? �Yes ❑ No 4ave all property slorm drainage connections to Ihe side sewer been identified and localed7 �Yes ❑No Has property been evaluated(or drainage deficiencies wilh findings communicated to properly owner? �Yes ❑No Installation Delails: . What lype and brand of BWD was installed at lhis si'e(Clean Check BWV, Grind r pump, etc.�: Where was the device,,�n�stalled(general description,atlach map)? ��L�L� 5�, �'� , �U1Q �� t a t'P�— —�T Was lhere any other sewer or slorm drainage v�ork om lete in con unction wit lhe ABWG vwrk'7 Is so please describe: /f t�II n"n ��.15 {� ( tuL� " �Gl! ��,T�,.P ,/� .�I�lth(1'��10,�r(/l Installation Checkli : Are all downspouts and site drainage disconnecled(rom upstream of the EiWD? �]Yes ❑ No Commails Does DWV positioning meel mm�mum slope requirement of>t%? �Yes ❑No Commenls: Can BWV be pulled a�t for inspection and maintenance afler loosening thumb screw?�Yes ❑No Is BNN locked into Ihc proper position and tliumb screw tighlened9 ❑Yes ❑ No Circ!^.fhe BINV cover:irrigation cover(landscape area)/traKc load bearing cover(drive surface)/access hatch(building) Was homeowner shovm the location of the installed N . �Yes ❑No Cor.;r�nts• �Property Ovmer's Sigaature: _ Date: ��_ Installer's Signalure: _ Date: �/��[�� Revision:2 1 1'hursday, October 02,2014