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` BACKWATER PREVENTION DEVICE f=1NAL <br /> �.F Tr INSTALLATION CHECKLIST <br /> � <br /> Inslallalion Ccmpany A'ame anri Cont�3d Inlu. _i���t�r� �„us¢�iqJ.1,2�'�c��5 �ZS'S_$1`7`�� 5 <br /> Dafe 6ackwatcr Prevention devicu (BIVD) ti;�.r; insl,illc�l l/a 5�/5� Unt�� ih��; I„n�i �v.r, �„�n��,��i���i _��"a�/�� I <br /> Installatien Prope�y Otvner N�me and Contacl I�do �E��� i���-`� ��`'..'!Z`� Z' �� '1 � _ I <br /> Property Addrese:1��� �f�l�--�`5 - �}-=� ----._ ._ - — ` <br /> _— i <br /> Pre•Instailation Inspection Checklist: ! <br /> f;n�iems must 6e checked'Yes'in order Jor a QtNll lo I:c r.onsidcicd loi inslalla(inu ' <br /> � <br /> Is tnere a basement or Ievel oi the house that is al or ncar,issuineJ s���.vcr main clev;d�on? � �Ycs I � ���� <br /> Are ihere fixtures in Ihe house Iccaled br.lotiti�lhe upsircairi sr.wer inanhnle rim eiev+�tion7� vf�Ycs � � Nc� <br /> Is '�^ ;ide se;ver currenity UNPROTECTED irnm sewer bar.kups (docs no!have a E34VU�nsl.iliecl�'�� ''�Ycs � �No � <br /> i <br /> Site Inspection Checklist: <br /> � <br /> �? i ilem;musf he cher.ked'Yes'Getore inspection is considered crnnpiere , <br /> 11'�s side se�:�er TV inspected irom building to sewci m�m? � �Yes [J Nn Condilion ____ _ __. _ _ <br /> �o-;s side se�r�zr have at least 15o sicpe irom the bwid;ng lo sevrer main� (✓j Yes � _ ] Nu Descril�c <br /> 1Ia�^;II building sewer drain connecGens fo the sid^sr.wcr I�erai idcnli�ied and loc:ded? � �Yr.s � � Plu , <br /> H3 re all oroperty storrn drainage connections to Ihe sidr, sewer�een identit�etl and locatr.d7 � �t Ycs � f Nu � <br /> Has prop�ify he�n evaluafed fur draina�c d��icicnr�^:;;;i�h liu� ,�. , + , .�� , ' � <br /> ` � 1-m� r.nimi'�u:li;:,,(ci. tu �i.�,,.�.�rP nrru•i - ! "� Y'its � �� Nn <br /> Ins;ailation Details: <br /> !Vh:it lypc and Lrand of BIND ti•ras inslalled at Ihis si(e(Clc;in Chrr.k RIW. Grind�i ��uinp,cl�;.) ,L'C1;try Ci4r�-� _ <br /> , I <br /> 1Vhere �vas ihe deviee inslailed(general descriptir,n-;�ilar.h map)�-�t?cl� k4l�� 2 �:r..� �;�L��= _ � <br /> lNas Ihero any olher sewer or storm drainage v�ork complelr.d in eonjunction v.�iUi Ihe GlM1'17 viuik? b;�so plc,:sc descri�e: _ � <br /> -- — - ------ . - -- - -- ---- --- -- i <br /> Installation Checklisl: j <br /> Are all downspouls and sitc dninage disconneded from upsln�am uf Ihc IIWD7 � '��::; ! � Nc� Cnnnncnts _.._. _. � <br /> Does RWD positinning meets minimum slopr. rr.yuircinent nl>1;;:� i �Ycs �. _� Nu Coinincid�,' <br /> Can 131ND lic pulletl nul(ui inspection and mainlenrinr.c ,dfci lo;c;r.nuu� tliuiuh :,acw'� �✓;Y�"; � ��Ju <br /> I5 BVUU Inr.kr.il inlo lhe ��roper positan and b screw Iiqlil��ncd7 ��Yes � � Nu <br /> Circlr. Ihu f3tiV�cover irrigation r.ove landscape are�1.�Irallic loari bearinq cover (dnvu surLir.c)l,�r.rr.s:,h;rt�ii ;lvddi�rl) <br /> 1Va5 pio�icrty a�vnr.r tih;r,rn Ih:� localiony iie msl�all� �f Ii4Vf17 � -rr,; ��� PJo Cwnnnvl; <br /> Pr:1;��u!y O�encr:s tiiq�cd� io / L'� _ �Z(�,e'_"_V _ - I):i,c �p � .�S C��`( j <br /> — — - Np", �- <br /> L^�si.�!I��� .: !;n�n,du�� �l� � �, �L�.._. -- - L).it� ��G�C � J � <br /> � ,. , .�,� .. , � , � ,� : � <br />