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BACKVYATER PREVENTION DEVICE PROGRANI <br />Our records indicate thal a backwater prevention device must be installed on the sewer <br />connection at the address identified on the enclosed letter. f'lease help us verify that our <br />informat�on is co�rect by answering the follo�ving questions about your propeRy' <br />Do you have a basement7 Yes No �j <br />If yes, does it have plumbing fixlures (sink, toilet, Floor drain, elc.)? Yes J No �j <br />Do you have a backwater valve on your se�ver line7 Yes ❑ No ❑ Don't Know'b! <br />Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br />Name: _ _� �jL.�_ M GGO���i�J C'/ <br />Property address: � • , <br />�� 23 �d i�A j►'� r�il�' � V�YIMQ, � FiV�P/Y —�� Z� � <br />Phone �: Phone 2 <br />yob z 3 � 56 ^ <br />Email: — -- Sr7lCGOV'A1JCl."� ����I.I� CQ%� <br />� 1 , � . ., ` �,. . i' ' ; <br />--� — -- — _ ,' _. __� � _.,� � ._ .... � �— -. ,. <br />