Laserfiche WebLink
i <br /> � � BACKWATER PREVENTION DEVICE FINAL <br /> . ' INSTALLATION CHECKLIST <br /> � <br /> � . <br /> � <br /> Insfaliation Company A�ame aid Confact Info:�;�i�'1 ��LL�S i"L-U�9��S it�!(j �N ( . _ <br /> pale �ackrrater Prevenlion dewce (BN�D)�vas installed:_ 5 i.5 Date lhis (orm vras completed: '�5 Co(i� <br /> Inseallztion Prooertv Owner Name and Gonfact Info��JL�� ����f�� �t\ y� � 'U Z � <br /> ProperlyAddress: �-�� �7'F�LF s. �•Y�--�-iT �V_,f���2-C� I --_— <br /> Pre•Installation Inspection Checklist: <br /> r�'�;'ams musf be checked 'Ves'in oraer for a BV✓G to be considered(or insiallation �/ <br /> Is ti,ere a 6asement or level oflthe house that is at or near assun�ed sewer main elevalion° (✓Yes ❑ t�'o <br /> A e there fixlures in the houseGocated below the upstream sev:er manholo rim elevation7 I�les ❑ I�b <br /> is lhe side se::�er currentty UNPROTECTED from sev;er backups(does not have a EV�IC insta4e�)? t�Ye; [. t�o <br /> Site Inspectior Checklist: ' <br /> �1�1�!2ms must be checked 'Yes'be%re inspection is cons+dered compiete <br /> Y;as side sewer N msp2cted from 6uilding to se�ver main? �s ❑ tio Cc�di,�on: <br /> Does sitle se�eer have at least i1%siope from the building to setver main'? [�Yes ❑ No Descri6e: <br /> r+a�:a all build�na sevrer drain connections to the sitle sewer been identified and located? C�es '] No <br /> Hai�e ali property storm drainaae connections to Ihe side se�ver been identifed and Iccated? Yes ❑No <br /> Has property been evaluated for drainage deri�iencies;vith findings communicated lo property o�•mer? [v�Yes ❑ �!c <br /> Installation Details: <br /> '.:h=t type and hrand o(BV��D v;as installed ai ihis site (Clean Chec:�e BV�N, Grinder pump, etc.):�an .,ec�,_ <br /> 1^:ha�e�vas the device instal!ed(general description, 2ttach map)'? ��T� _ <br /> !ia�Ihere any olher sewer or storm drainage e+ork completed in conjunction w!lh Ihe BWD work? Is so please desr.ribe: .,ua <br /> � <br /> Installation Checklist: � <br /> n�r, al� Ao+�+nspculs and sile drainaye disconnected trom upstream of the BWU? [�les ❑ No Comments <br /> [!nes f3WD posilioniny meets minimum slope requirement o(>1%? �Yes ❑ No Coinmenls _ <br /> C.�n RIND be pulied oul for ins{iectien and main(enance al�er loosening thumb screvr? [��Yes ❑ Uo <br /> Is F..'JQ locked iNo the pra er f',�osition and fhumb screv�tiahtened'? �s ❑ No <br /> s��W�2CcU E2 <br /> Cncle the B1ND cover. irriye!�!retrver(landscape area)I traffic loatl b ering cover(drive suriace)!access halch(building) <br /> V:as properiy o���ner shotivn (he'�localio oi e�i�alled BWD? _ Yes ❑No Comments: <br /> I � � f <br /> Pro�rt�O���ne�'s Si neture: � ___ D�a.te: � � /% <br /> Instatier's Signature: '���%f� �. ��ks-„ Dale:_�_� <br /> � <br /> Revision 7 i Monday, �entember 1;, 2014 <br />