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� _ <br /> _ � <br /> BACKWA.Tt:R pREVENTION DEVICE PROGRAM <br /> Our records 4idicate :n.. a bach:�ater prevenlion device musl be installed on the sewer <br /> cannection at the adC, idenlifed on the enclosed leller. Please help us verify lhat our <br /> information is correct '.. �nswering Ihe(ollowiny questions about your property <br /> Do you have a hasemenl? Yes � No ❑ <br /> I(yes, does il have plc �bing fixWres (sink, toilel, iloor drain, etc )? Yes [�`No ❑ <br /> Do you have a backv✓atar valve'on your sewer line? Ycs ❑ No ❑ Don'; Know ,(� <br /> Do you have a grinder pump in your basement7 Yes ❑ No �i(J Don'1 I<now ❑ <br /> Name�-f��..A.L,�—_� -Lf1�__S_- <br /> Prope�ty address��,�_2_[.�'�C./'f_/;j�l1•t%C�-y�' — <br /> Fhone t �?G�1`fe_?3��-- Phonc 2.�0_L_�1'�'[��� <br /> [mail -�c•-�h�.T1C_�!/�;S �d./�7.5��CO���'-- <br /> -- , ��.;F.�I� II,,,tl '� 9tt.� N �:.+.,_- <br /> ' • - r --- - � :�:,ihL�,t�.��e�9�i;6i��.��ll'��7��.4 � � ,:�1�.1..�_J'K'��;'t11.4iF.,�' <br /> - - - - -- � - � - - -- -- -- -� - - _ _.. <br />