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BACKWATER PR�VENTION DEVICE PFtOGRAM <br />Our records indicafe that a backwater prevenlion device must be installed on the se�.ver <br />connection at the address ideniified on the enclosed letter. Please help us verify that our <br />informafion is correct 6y ans�;�ering the follo�.ving questions about your property. <br />�o you have a basement7 Yes � No ❑ <br />If yes, does it have plumbing fixWres (sink, toilet, floor drain, elc.)? Yes � No ❑ <br />Do you have a 6ackwater valve on your sewer line7 Yes ❑ No � Don't Know ❑ <br />Do you have a grinder pump in your 6asement? Yes ❑ No � Don't Kno�v ❑ <br />Name: � �"v � .rJ Zf�R.t� <br />Property address: � ��%G ���� s r <br />Phone 1: '(,�V-� � 23 ��� Phone 2 <br />Email: /� QN � =Z . c�..lt-T ✓` <br />i <br />. <br />, <br />.t lcfl�i.� t� f u�..:i:... .. . � .�: � <br />,r.v.:.�L_ �� <br />