Laserfiche WebLink
BACKWATER PREVENTION DEVICF F�NAL <br />INSTALLATION CHECKLIST <br />Insta;lation Company Name and Con(act Inio: t�-1 ��(� t' l�J.w�yf'�� <br />� <br />Date Back�vater Preven6on device (BVJD) e:as insLaCed:�� Date tnis fom tvas cempleted: ��� <br />Insta!lation Proper�y Ov+ner Name and Cont�ct I�fo� ����� ��T � <br />ProperfyAddrass: '�C12Z �,��cx_(iQ_ �j1U/ ��iJe <br />Pre-Installation Inspec6on Checklist• <br />AII ;tems must 6e checked 'Yes' i.� ordet (er a 8l'VD to be corsioerd forinsta!!at'o�; � <br />Is therz a tasement cr Izvel :,t the house th�! i; af or ne�r assumed sewer m2in e!evatbn'l �j'fes ❑ ��o <br />� <br />Pre there fix�ures in the ncuse Ic„ate� baloa� tne upstream se�,ver manhole r.m e'evation7 �] Y=.s ❑ No <br />I <br />Is me side se�,tic� Gtii i enJy UNPRO'I ECTED trom sevrer backups (do=s net have a 64VD irstalled)9 �] Yes ❑ N� <br />Site Inspection Cheeklist: <br />�'I ifems musf be chscksd `Yas' b=fo� inspec6cn is ccns dered complefe <br />�'las sde se�n•er N irspected fmm building'.o se��ver m2in? �] Yes ❑ No Ccndiron: <br />�ces sid� sev;er have zt leest 1�6 s!ope from t`e building to s�evrer mz;n? �'fes ❑ N� Describe: <br />Fave atl bui!dina ser+er drain connec'�or�s to the side serrer heen idenGfed end I�cated? '� Yes ❑ No <br />Havz all orope; y storm dr2!nage conr,ecticns lo the sids s�wer been i�:n'�i5zd and Iccateci? L�f Yes ❑ No <br />i <br />Has p,opery Eeen evaluated for d�ain2ge deficienci� ���nh frtlings communicated to proo°rty d�a�n�r'? [�l'es ❑ IJo <br />Installation Details: �- <br />Vlhat type ard brand of 3WD was instalied ai this �Clean Check B1�W, Gri der pump, etc.): <br />4Vhere v;as the device insta;ied (general description, atiacl�i r�cp . ti��`ai���� y� � k-� �� <br />VJas fhere any other sewer cr stortn drainage �vorlc comp!eted in conjunction vmh the 8wD work? Is so ple2se descnbe: _ <br />Installation Chocklist: <br />Are all dovanspcuts and site drainage disconnecled from upstream of the BWD1 e] Yes ❑ No Cemmen(s: <br />Dees BWD positioning meets minimum slope requirement of >i°��7 � Yes ❑ No Comments: <br />Can BWD be pulled out for inspection and m�infenance aPer Icoseni g thumb screv�l �] Yes ❑ Ao <br />Is B'.ND locked into tha proper posiligu.acul-8�txnbs rew Gghtenedl Yes ❑ No <br />C�rcie the 64VD cov e���img on crover (land=cape area} a��ic load earing co��er (dnve surface) I access hatch (building) <br />1"!as properfy ovmer shaa;mL�e.lecaUon of iha' ' ND? � Yes ❑ No Comments: <br />Property Oemers Signature: i� Q°�e� <br />Insfallers Signature: !f/ Dale: � �� <br />Revision: 2 \`� 1 friday, September 12, 2014 <br />