Laserfiche WebLink
i <br /> � <br /> 1 <br /> ����°���'�� l���°���9`�6�� ����G� �6�.�� 4 <br /> b������_��.���'E��9 �����&���?�'�` ' <br /> m._.�.,,�„�,._�___. __,�. � <br /> — -�-.�r..�.,...� � <br /> Ins�alla5ori Comoany N2me and Contact Inio: MUgn ��(�,y�,,;,, L �` �-- ' <br /> ti lar ��� ��6� � <br /> Daie Bach�:ater Rreveniion de��ic2(Bl4�D)was insialied: �"-z 7-�/� - — ' <br /> irsfaNsiion Pro e � u -----Date ihis form t�;es completed: F�-i.�7-i� � <br /> F �} Otivner t�am,, and Ceniact Inio: �`1e r��I 7 0(�,� v �r�y (�� � `� : <br /> °�oF°rYP.ddress: a I o f �-jZ ( U � i.✓th-r-�.,v� /-}- i <br /> � ; <br /> Pre•In:iaUaEon In=��_finn Checkiist: -- � � <br /> !'i�literum���,pochecked'Yes'ino,�derioraBNOfobe r � <br /> cansioered,orinstelfation � <br /> �s the,:a b2sement or!evel oi ti�e�ous2 ih2[i;at ornear assumed se�cer main eiet�z;ion?�Yes ❑Mo 1 <br /> AI0 If1EfQ 1L;iL'ie; in the ho!�se loc�iad belo�v fhB U,�7S�YB8Gi SE'Ser manhclo;im e�°V"cPDf17 u}'og �110 � <br /> fs t�5e side sev;er currertly UP;PROTECTcD�rom se;;er Eackups(ooes noi have a B�VD i�si�Ced}?[�(y�s �]A'o ' <br /> � <br /> Si��fnspection Checklis4; � <br /> A�l�tems mustbe checksd 1'es'b�iore ir,speclion rs considsi�ed complete s.,-,t �fi t � <br /> ! <br /> ��:�?5 Si08 5?l;�ar iV inspected iron buildir 0 � � � h U�rhn <br /> g t set�,er main? �'Yes ❑!�o Condition: `'�cv„�,,.�� �o� ` ' <br /> Dee�side se�,ver hGve ai I�ast 1°;slope from the building to ssr,zr main? � <br /> Have ail buildin � -�JYzs ❑i\o D>scrioe: . <br /> g..ewer drain connecGons to the side sewer been iden�8ed and located? �kj Yes ❑ No <br /> 43ve 2;1 p;aper�y stcrm drain?ge qnnections io�he side se�,ver been idenufied and lorled7 (�yE; ��y� <br /> Has preper'�y been evaluaieo iorar�inags denciencies w'r,h fin�irgs cammunicated to proper�y ovrner? [�Y�,� <br /> fnst�flaiion De�iis: � �!o <br /> 1^,'hat h�pe�nd 6rand of 81�UD v;as insta�ed at ihis site(C!aan Chec4 BINV, Grinde;pump,etc.J; ��/�"2 �'� � ,� <br /> !rd'ne�u•as,he device Insia�led(general descriptian,aftach map}9 i <br /> �=��-'-.,r <br /> _�..._.......r_, � <br /> � <br /> �Nas th?ra any�ther satvercr sionn drainaga e;org comple(ed in conjunstion tvith ths BING m•or9?Is so piease d,scriba:� � <br /> ---- /1//�;- — . <br /> Installation Ch:cL•IisC; ' — •--- � <br /> Are afl dcv;nspouts and siie drainage disconnecied from upsfream ot ihe Ci1ND? I <br /> �Yes ❑No Cammsnis ! <br /> Daes 61�UD positioning meets minimum slope rzquiremeni of>1''l0? 0 Yes ❑ No Cemmenfs: ' <br /> Can BIND be oulied out for inspec�ion end mainienancs aFer loosening Ihumb screv��? � <br /> Is EWD locicetl into the proper position and ihumb scre�r.�tightenedl � ��,�'`o � <br /> C.7�-C3 no { <br /> Circl�the EWD cover, irrigation cover(landscape are2)/trafr�c load beering cover(drive sur�ace)!access haich(buildingy�%� <br /> Ndzs propery ot;�ner shotvn the location of the instaued BWD7 �'yes �Ro Comments� ' <br /> Propery O�vner's uionature: Da,e: ' <br /> fnsf211ers Signafure:�f�-- Dafe; fl�- ,2 7— i S�' � <br /> i <br /> Revisfon:2 1 � <br /> fAondzy,Septemb:r 15,2019 f <br /> � <br />