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J <br />BACKWATER PREVENTION DEVICE FROGRAM <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? YesA No ❑ <br />If yes, does it have plumbing fixtures (sink, toilet, floor drain, etc.)? Yes'K1 No ❑ <br />Do you have a backwater valve on your sewer line? Yes E] No E] Don't Know <br />Do you have a grinder pump in your basement? Yes No ❑ Don't Know ❑ <br />Name: <br />Property address: �J 1 l I <br />Phone 1.`rl�' 2`1�Z' �I 1l3 l� �Phone 2: L4 v5 - ZS 2 — <br />Email: <br />