Laserfiche WebLink
2013 LARGE STORM RESPONSE PAPER FORM CHECKLIST <br />Dale of insoec6on: �/ �� `i 'I 3 Inspected By: %� rl r_K ��J� �� C f� _ <br />Address: �C( r ? s.+� s T _ Service Request Number. ! u.� 7��a <br />Resident: I onCl P�lIACic tr+mer? (�YES � NO <br />PhoneNumber: `-IJ)r- >> 1- �/OdS Email: 1 iLd�Ni i"n�i ' No1r+�.� rr--. <br />General Buildi�g Details: <br />Is this building within the comhined sewar area? [� YES ❑� <br />Dces Ihe building have a backwaler valvc (6WV}? ❑ YES NO <br />Dces the huilding have ;, sump pump? � YES �'NO <br />Storm Event Details: <br />Does Ihe building have a basement? ❑ YES ❑ NO <br />(If yesl Was BWV ins(alied (nrough Ciry program ❑ YES ❑ NO . <br />Does Ihe building have a grinder pump? ❑ YES �0 <br />Where did wafer enlering building come fmm? � SURFACE FLOW � GROUNDYJATER [Q SEVJER BACKUP - FtXfit7R€S ❑ UNKNOWN <br />Delails: �c,.nc �nyc trlt��y�• nPic.v )° CIflNOJI "<JJI�M1'i v: .�� n�Or� ✓ �Ir�.� .I ih_< ,�.G�-� <br />Where did waler go vnthin the huilding9 � dASEMENT PERIMETER ❑ BASEMENT NEAR fIXTURES � OTHER <br />Details: F�o��c..� I�Af<°f1t.V-� .4�.IJ0..: w��ri H;.�ir,<--�+.o i'�2�iryc� <br />Site 06scrvations: <br />Downspoul l site grading issues noled: _tir,I [��)v, c. . �� li r� r <br />Building elevation relative lo sevrer and surtounding arca issues noled _ <br />Sife pump issues noted: <br />Historica� Inlormation I Othcr In(orrttation: <br />Prewous "floodino' issue Service Requesls al address. <br />Previous'ilaoding' issues noled 6y homeawner. <br />6c <br />Recent stormwaler 1 sewer projecls compleled in area Proposed s(ortnwater I sewer pmjects in area: <br />Propedy owner inlerested in beginning City Backwater Vaive Program al address j�]-'�(ES � NO Dela ls: <br />Noles: �iM- t�a5 Dtn/ �� tlt�.� 0✓7 �N BAl�rc•v� �ia,c O.A n. �A.•(c r_An..9 a3 iUoT F..iai.: <br />.y <br />...nt-2 A� n.:lEn o.v l l� � �i - i St. �< t' .t� F/'c'+ L-�' HCF�,� �D �)A�cr�r� <br />f\Ai SCJCM1N� C�cS �t.,K.'li.�..a L� "� /-r� '�1'� �Lm�4nly JA.`\ 1-! <C.t.�' i�.��. <br />Revision: 3 TRW <br />Monday, Septem6er 09, 2013 <br />