Laserfiche WebLink
� <br /> � <br /> �ACE��7'�R p���6E9V`��AN ��"V9C� ��NA�. <br /> �f�S1P�����'��6� ��9��&��a�� �� <br /> ...��.,�____.'_.—�.__�.�,�.�_ � <br /> �-�--v.��_ <br /> ------� <br /> �nstau,5on Comoany Nems and Contad Info: �'�U� (�(,�,�, ,,, � <br /> h� ►a� ��� ��6� <br /> Oaie Eacin;�ater Preveniion device(BVJpj was ins;211ed: �-z�-� <br /> ---_i Date ihis form v,as completed: d'-27-i1"- <br /> Installafien Properly Owner Name and Con'tact Info: M�'r{e I 7 0(�r v r v (�� � ,�� <br /> FropertyAddress: � � 0 1 ¢a ( U � wL�.��.� � , <br /> v-c <br /> Prc•Insia11�5on lnspec`�on Checkfist: <br /> kll item;must be checked'Yes'in oNeriora BV/O lo be cons�tlered;orinstalfafion <br /> �s there a b2sement or level oi tne housz fhai is at��r near zssumed se�cer maln elevatlon?[�Yes ❑,!o <br /> Are!here»;fu;es in the hou:e loc�ted be�o�ti�ths up;;rea�7 seu�sr manhole rim eleva6onl�Ye: ❑i lo <br /> Is tha sids se�tier currenUy UNPROTECTED fmm esvrer 6aekups(does noi have a Bl4�D instdiled)?�j yes ❑No <br /> Sife Inspecuon Checklisf; <br /> A!1 itsr,s musf be a5ec;ted`Yes'bair,re inspection is considered camplete s,;,-.� y�o d c h u�f�-,n <br /> '✓i�as side see�er N inspe�ted irom building to seti:rer ma(n7 (_R Yes ❑,\o Condition: `�� ��"�� <br /> Does s�de se.ver have ai least 1%s;o�from the building to sev,^�r mainl � � cfo M1 ` <br /> Nave 2't building se�n�er drain connec6ons to tho side sewer been iden5ned an��te� No De cribe: <br /> N2��e all prope ,ry storm drainaee connections to the side se�.�er bec Q ❑ No <br /> n identiiied and located? �'1'es ❑ iVo <br /> Has property hoen evaD�a,ed ferdrainage dericienc;es idr,h findings communicated to proFerty ovmer? �1'es p r�o <br /> Ins[aflaiion Oe[ails: <br /> 4Vhot q�pe�nd br�nd of BlN�7 was insta�ed at this site(Clean Chec!�BVVV, Grnder pump,etc,): ������� V� � � <br /> Whe��ras tha device Insialled(geneta(descriptlon,attach map)? b�,��.,-.�,.,e- <br /> — - _--�.._._,.,,�„ <br /> �vas Ihere any other sewer or stoim drainag���komp!sted in c�njunstion teilh the 81h�D w�or.<?Is so pf�ase doscribe:_' ; <br /> Ins�allation Ched;list: ' —' — <br /> 4re all oo;vnspouts and siie drainage disconnocied from upstream of the BWD? [�rj�Yes []No Commenis: <br /> Does BVUD positioning meets minimum slope requiremeniof>1%? �Yes ❑No Cemmenis: <br /> Can BWD be pulletl out for inspe��ion end mainienance after wosening thumb screwl ���p <br /> Is BUVD lodced into the proper position and ihumb scr=_vi 6ghtened? []y�s{J No <br /> Circle the BIND cover,irrigation co��ar(landscapP area)!Vaftic losd bearing cro�rer(drive surfac�)!access haich(buildingy�%�' <br /> Vt�as propeRy o��mer shown the location of the installsd BWD7 �'y� I]No Comments� <br /> Property Owners Signature; Date: <br /> Installer's Signature:��"yf Date; c`�- ,2 7- i� <br /> Revislon:2 1 Monday,September 15,2014 <br /> i <br />