Laserfiche WebLink
'' BACKWATER PREVERTION DEVICE FINAL <br /> INSTAI_LATION CHECKLIST <br /> , <br /> Inslzllation C� mpany ^Jame and Contact Info: A�'�'1 P��LL�S ��-1.��'L1(� IiU��} . �N C . <br /> Date Dack�;�ater Prevenlion deviee (BI��D)was instailed: ! 2/2�t I`i Date lhis form was completed: 2� / 5 <br /> Installalion Properiy O�;�ner Plame and Contact �0�0: ��A��c_ s �ol L��o�zr <br /> ProperlyAddress: �2�.1�LmC_IC��' LL�� /i1�_� �ves�4 � U-7�t S'S3�—�� <br /> Pre-Installation Ir.apection Checklist: <br /> All ifems must be checked '1'es'in order for a BWD to be considered/or installalron - <br /> Is there a basemenf or level of the house ihat is at or near assumed se��ver main elevation7 c Yes ❑No <br /> .Are there (ixlures in ihe ho�ise located below the upstream se�ver manholn. rim elevation?�Yes ❑ N <br /> Is th�side sev:er currently UNPROT[CTED irom se�•,er backups (does not have a BIND inslalled)? J Yes [� No <br /> Site Inspection Checklist: � <br /> l411 ilems ntust be r.hecked 'Yes'before inspection is cnnsidered compfete I <br /> 'oVas side sei�;er N inspected from buildinn to sewer main? [�Yes ❑ No Condition: ! <br /> Does side setiver have at least t%slcae from the building to sPv�er main7 �Yes ❑V,o_,(qescribe: <br /> Have all buildiny sea�er drain connections io the side sewer been idenli(ied and located? ��J Yes ❑ No <br /> f lave all property stonn drainage connections to the side se�ver been idenlified and Icca:ed7 �Yes ❑ No <br /> Has proporty been evaluated for drainage deFir,iencies with lindings communicafed to properfy otvner? [�Yes ❑ No <br /> Installation Details: <br /> 1What type and brand of Fi14'D�ti�as inslalled at this site�Clean Check BVN/, Grinder pump,etc.); C j�" Cl..c�� <br /> lNi�,ere was the dev;ce installed(general desoriplion, aflach map)? _h� ��' b��KSP �w Lo� r�e,r <br /> �1'as there any other sewer or sturm drainage vrork completed io conjunclion wilh lhe BN'��vork? Is so please describe: ._ <br /> Inslallation Checklist: <br /> ive all ciownspou�s �intl site drainage disconnecfed from upslream of the � D� � Yes ❑ No Commer,is_i_, <br /> Uoes 8WD positioning n�eels minimum slope requiremenl of>1%? (_ Yes ❑ No Co�nments: � <br /> Can BUJD be pulletl oul lor inspection and maintenance a8er Ieosening I�h rnb screw? �Yes ❑ No <br /> Is GbVD locked into the proper position and thumb sc:rew tighlened? [✓; Yes ❑ No <br /> � �� � � <br /> Circie lhe BWD cover. irnga6on cover(landscape area)1 traKic load bearing cover(dnve surface)�ae�haich(bwld g) � <br /> VVas properly owner shown lhe loc2tion of lhe inslallr,d B14�D? (�Yes ❑No Commenls:_ <br /> Pioperfy�„ner's 5ignaturr;: �"`�'�-' Date __ <br /> Installer'sSianalure �� � Oaie: 2�iO��S <br /> I <br /> Revision: 2 1 iYinnday, Septem6er 15, 2014 I <br />