2130 VIRGINIA AVE 2022-05-16 - Laserfiche WebLink

��ii(i 6�4.��ii��R �REV�i��10�! ��l�I�E FI��L @t��it�,��.�l� @�� :FiE�KLPST In;tallation Company Name and Con(2cl Inic,. 9/? / o j�/G. rr /7ii� ��7 �/ S�7 Date Baclnvater Preventicn device (BIND1 ��;as inslalled ��/ /.r Dale ihis (orm vras compleled: Z�// /.� Installalion Property Ovmer �ame and Con(act Info: ,�d..�u z-.�-,, �h ��cE� 7z �—s631, Properf; Addre;s: 't ��G V ; rq • � . c� �iv� Pre-Installation Inspection Checklist: /�!I dems musf be checFed `Yes' in order lor a BI�dD to be considered (o,- installation Is there a basement er level of the hous= that is at or near assumed sewer main ele��ation7 � Yes ❑ �o Are Ihere fixtures in the hous� located belovr the upstream sewer manhole rim elevation? Yes ❑ No Is �he side se�v2r currentl�- UhPROTECTED irom setil�er backups (does nct ha�re a BUi�D inslal!ed}? j]� Yes ❑ �'o Site Inspection Checklist: J Af� i(erns m�st be checked 'Yes' before inspection is considered compfe!e Vi�as side se�ver TV inspected from building to se;var m,=.in? � Yes ❑ No Condition: Does side set�,er have at leasi 1%slope irom the building to se��er main? j� Yes ❑ No Describe: _ Have all buifding seerer drain conn�ctions lo lhe side seH�er been iden(i(ied and loca(ed? � Yes ❑ No Ha�,�e a!I pror,erty storm drainage conneclions 10 ;he side sev;er been identi ied and loczted %� Yes ❑ Vo Has propery been evalualed tor drainage defciencies a:ith f noinqs ccmmunicated to property o�vner7 �] Yes ❑ No Installation Details: lVhat typ� and brand o( BIND v;as installed at this site �lean Check 61'� , rindar pun��p, etc): Vdhere vras ihe device installed (general descrio n.��tachmati}?��J ,>n,-/ v� �/� ;� R�r�/i L.ftH�Z_ N�as th2re any o1h�l 5�1'rer or slonn drainage v�ork completed in con�unclion ��ith Ihe Blh'D v+crk? Is so please describ��: _ _ �L�S r /J �fCc�+/�ecY `7� c�I? lk�� wi+ .'-:. f //.i � Installation ChecklisL• Are all dov�nspouls 2nd sile drainage disconnecled irom upslream of the BV��C�? kll �s ❑ No Commenis: Does BWD positioniny meets minimum slope reauirement af > 1°i,? �'S'es ❑ No Comments: Can BI'JD be pulled oul for inspection and maintenance af(er loosening Ihumb scre�v? �Yes ❑ No !s Bl4�D locked inlo the proper posilion and thumb screrd tightened? (' �Yes ❑ No Grr,!e the Bl4�D cover. irrigafion r,over (landscape areaJ 1 traific load bearing cover (drive sur(ace) I c ess lialch (builtl' in � 1%�'as property owner shown the location of lhe insfalled 9WD? � Yes ❑ IJo Comments: Properiy OH•ner's Signature: v• Date: Z�// / S� Ins�aller's Signatur .� Dzte: 2///// SJ _ _� Revision: 2 7 Monday, September i5, �Oi4