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B/-1CKWATER PREVENTION DEVICE FINAL <br /> Ev -rr INSTALLATION CHECKLIST <br /> ( i . _ <br /> � -s `I z s-S"��• ��a� <br /> fnslallation Cornpany Nainr an�i(,onlacl In(o �eNude�,p,ys��.x.7(o%/Jd2v�Cc,- <br /> ' - - - � - _-------- --. <br /> Date Backwater Provenlinn dr.vir.e(B�4'D)�vas ins.l,dlcd ���L7/),S I),dc Ihis Inim w:r;cuniplcL�d: �/ZJ �S. <br /> Inslallaiion Property Ovrner Name and Conla�l In(n �c�5i�l 17� �Z� �1� ' 7�3-� <br /> .I - — --- - ..._. _—.._..-.. <br /> Froperiy�ddress:_�-]Z`1 j1•��!M�i� <br /> - -/ _. _---- __ . <br /> Pre-Installation inspection Checklisl: <br /> /ll!items tnusl6e r.hi�rkcd'Yr.s'in nrder 1oi a BWI)lo Dr,cvnsidcicd lor inslall;�fion <br /> Is Ihcre a basement or level of Ihe house Ihal is al oi near;ssuinr.d scc�cr m;iin clev,ilion?� Ycs � �No <br /> Are Ihere fixtures in(he house lo�aled below thc up;t«aam;;r.wr.i m;mhole rim clr.valion7�U{'�'s � �No <br /> Is lhe side sewer cuuenlly UNPROTFCTED Irom sewr,r hackups(doc::nn(I�ave a f3lND insl;dlecl)7� +�Ycc; � J No <br /> Site Inspection Chcr.klist: <br /> All items rnusf bc checkcd'Ycs'bclorc inspection is cv��sidr.�ed complcic <br /> VJas side se�vcr N inspecled trom huildmg to sewer main? ��s ❑No Condilion ___ ,_ <br /> Does side sr,wei have al Icast 1"/o slope(rom Ihe building lo scvlr.i main? �_ Yes � .� No Dr.scnhe _ _ <br /> Have all buildhiy sewerdriin connr,r,lions to Ihe side sewei I,r.en identifir.d and loc;ded7 �✓j Ycs � �Nu <br /> Havc all properiy stonn dninage r,onnr.r,fions lo Ihe sida sc�ver bcen idcnlified;md lor.aled7 �:'�Yr.:; � � Nn <br /> Has ptoperfy been r.vnluated for drainage deficienr.ies wilh findings i:nnunnnicaled I�>prnpcily ownri? ��Yis � �Nu <br /> Installation Dclails: / <br /> VJhal lype and brancl of f3WDwas inslalled af Ihis silr. (Clr.;ui Chcr.k DWV,Grindcr P�����P, �'��-) (����_�µOG� <br /> Where was Ihr,dr.vir.r,inslalleA(gencral desr,riplion, allar.h map)7��_y/}'� �� � CA2�-I d� c`1�?��1�t e� <br /> Was theie any other sewr,r or�s(lornt drainat�e work complcfed in conjunr.�ion wilh Ihe RWD wuik? I�.;su pla�;c dr.sr,�ibe:_ _ <br /> --- 1�`-U -- _ _ . ---------- <br /> Installation ChecklisL <br /> Are all downspoulti�md;ih:dr�inage disr,onnecG:d irom upshca�n ul Ihc BINI)7 � � Ycs �✓�No Cuinmr.nls. �AISP�c.T�J�2 <br /> `��_ <br /> Dor,s 13Wp posiiioning mr.ek minimum;lope requircmnnl nl>1'%7 ��Ycs �_ � IJn f;omnu•id:; <br /> _. _ _ _ <br /> Can HWD bc pullr.d oul fur inspcc.liun,�ntl m,iiidr.nnnr.c;dlci luu:;r.ninq Ilnunb:;ci�:w? �✓Yis; � � IJu <br /> Is[3WU lor.ked inln Ihc proprc on)and lhumb sar,w liqhhvicd'� ��Ycs (_�Nn <br /> Citr.lc Ihe RWD r.uvni_ � iga ion co�e(�landsr,apc�tca)I Irdlic In�id bcaimg covr.r (diivc siularc)I;ir�,rs•, li�ticli(biiildmq) <br /> 4Vas pio��cil; , r; .r., , ic Inoalion ol lhr,ins�allcd ifWI)7 � Ycs � � Nu Cummcut; <br /> Prop��ily Ovrncr'; Siqnnl rr..( / y�p�v�,.��, -j "-'--1'l;ilc �/���� 5� <br /> In::iillci :: :;n�n,iiiur �,L�(�,1L-� lX� k�`-. I):dr ! �`� �5� <br /> � � / / <br /> Iloe�.i��n ' I i\1nnrL���. '.i��d�•inl„�� I'. �nl I <br />