1917 WETMORE AVE 2022-05-17 - Laserfiche WebLink

i �AC�f16d41'�R PR�VEN�'�0� DE1/ICE FINAL. � 6�dST'ALI��I�� FiECI�LIST : InstzllationCompanyNameandContecUnto: Moen ��,r,�i:., y'�jf ��U ��60 � Dste Backwater Prevenlion device(BW,))was installed:�S'�`'t "7 Date this form v�as completed: �—�q —�� ' ; Installalion Property Owner Name and Contacl info:_ �� do I�,� (J'v t�r s.J,,� Proparty Address:__ (��/7 �-.-l.ch��r.� �,ti y�S' K rb— I y ��( • Pra•Installetion Inspectlon Checklisf: Alf items must be ahecked'Yes'in order for a BN�D to 6e considered forinstellafion Is thare a basement or ievel oi the house ihat is at or near assumed sewer main elevatlon7(�Yes ❑No Are fhere nxtures in the house located below the upslream sewer manhole rim elevation7�j Yes ❑No is the sitlo sewer currenUy UNPROTECTED irom se�ver backups{does nol have a BWD insialled)7 �Yes ❑Ab Sifc Inspection Checklisf: AII items musl 6e che�ked'Yes'heioro inspection is considered cnmplete � Was side sewer N inspected irom building to se��,�er main7 ,�Yes ❑No Condition: U � Does slde sevrer have a�least 1'Ya slope hom the building to sewer main? �Yes ❑No Descrlbe: I-iave ail buiiding sewer drain connections to the sido sewer beon identined and loeated? Q�Yes ❑No � Have ail property storm drainage connections to the side sewer been identi6ed and lorated? �Yes ❑No Has propeiiy been evaluofed for drainage deiiciencies with findings cort�municaled to properiy ovmer? (�Yes ❑No . Instaliafion Detalls: What type and brand oi BWD was inslalled at this site{Clean Check 6N1V,Grinder pump,e(c.): (/wZ (rY..G,/L Where tives the device insteiled(general descdpUon,attach map)? ___/j�_ie.n c� un•t e.� S�i�✓ � _� VJas lhere any olher s2wer or slonn drainac�e work compleied in conjunction wdh lhe BWD work?Is so please describo: _ if/J� Installatlon ChecicllsF: Are all downspouts and siie drainage disconnecfed irom upstream of lhe BWD? �C(Yes ❑No Comments� _. �oes BWD positloning meets minfmum slope requirement of>1°lo?�Yes—�� Commenfs: Can BVVD be pulled out for inspection and mainienance after loosening ihumb sr,reva? t�o Is BUVD locked into the pmper positlon and thumb screw tighfenedl No � Circlo the 8WD cover.irripation cover(la ssape area)/traffic load bearing cover(drive surface)1 acr.ess haich(building) Was properiy owner shown the lor.ation of the Instailed BWD7 �Yes ❑�o Comments� Property Ovrner's Signaluro: Date: Inslaliers Signature:`�� -��'----- Date; ��1�� ^ Revisfon:2 t Monday,Septemher 15,2014 �