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(AVM obi' dGt f0 e(¢vah- <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. 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 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 Know [H, <br /> Do you have a grinder pump�in your basement? Yes El No ❑ Don't Know IR <br /> Name: 4,t�GCf�� ! USE <br /> Property address: 7'7/7 L <br /> Phone 1: —+} / / Phone 2: <br /> Email: <br />