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--- _ — � <br /> � 2013 LARGE STORM RESPONSE PAPER FORM CHECKLIST , <br /> e�. I <br /> , �. n�o a.� � <br /> D21e o(inspecUon.�� Inspecled By.�-�S/��✓ <br /> Address _K�.I) ! ,� �P/l.�l,fi�� Service Requesl Number � <br /> ReadenC '/ ��!/C U�'�r"'�^"Uf Oxner� ' YES ONO I <br /> FhoneNumbcr. Ema9 ___ _ j <br /> I <br /> General Building Details � <br /> Is this bu��.id•.ng wlh�m Ine com6ined sewer area? YES �NO �aes the bulld�na have a basemenl? YES 0 tJ0 �� <br /> Does the bmldmg hwe a hackrvater va've(BIN�? ❑YES NO (II��es)1Nas BWV mstalled Ihrough Cily nroaram ❑YES � IJO ,� <br /> [;oes the bwlding have a sump pump? ❑YES d0 Does Ihe bmldinq havc a grindsr pump� ❑YES f]7J0 i <br /> Storm Event Details: -fZ��,�� r� � � C�(�,Ctti, G� G I <br /> �e�,� �z'�K, � <br /> 1'Jhere tlid waler enlenng bui�dmg r,ome from� Q SURFAC[ FL04N ❑GRJUtJD1�ATER SE4VcR BACKUP-FlXTU ES �UWNNO'NW <br /> Deta�'s — - <br /> � VJhere d��d water go eiilhin Ihe 6udding� �ASEE4ENT PeRi�d`tl ER �]BAS[kiEN i NEHR FIXT RES 0 O1HER <br /> �, Deta�ls. Y� 5� �/�'? /,�er�-`r. n ��j� ILf i i7 (,JLv7�/,E- /�"Il�C�G'v)P �L� <br /> - f� <br /> �—� I <br /> � Sile Obscrvations: � <br /> �� Downspoul l sde gradng issues nated U-�� �� S�C'"7/ W i C 1�'�/�_ _—__--_-.--- <br /> I <br /> � pudtlmg e!c�ation relalive to sewer and surrounAing area issues noted� �_�W _�7� O /7 (r���(,c'L`'- <br /> �� 1,� oul� :,�4-'. <br /> �. Sile p-•iiP issucs nofed _.�+._ - - —-- --- <br /> /1 � <br /> � Hislorical Inlormation I Othcr Informalion: Z S �I�� � ��� �4��Lc r � �� �� � � � - <br /> � Previous"Oooding"issue Servlce Rnquesls at address _/C10 nt_ _�j-,a L✓�._ ---_- - - . -- ---.- — - <br /> � <br /> Previous'llooAing"issues noted by homeowncr._���rr�---- __- —. --- <br /> , Recent stormwaler I sewer projects completed m area _Proposed stormwater I sev.•er projer,is in area � <br /> Prope�ly owncr inleresled in begmning City 6ackwaler Valve Program at atldress YES �NO Oetails <br /> � Wotes� /lc'Glfi�n ca�.s�d/ .tofki,C� -_et'JK�/l���l ' — , <br /> Rcvisiorr 3 TRW 1 lhursday, Sep[cmber O5, 2013 <br />