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' BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on your <br /> sewer connection to comply with the new ordinance. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? Yes Xit No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes ❑ No <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Knows <br /> Do you have a grinder pump in your basement? Yes ElNo1O Don't Know <br /> D ❑ <br /> Name: f � W\ \(J <br /> Property address: 6 3 WJr \ Arck. <br /> Phone 1: t1Z5-3c 7 Phone 2: <br /> Email: <br />