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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 ® 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 Ar.No ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know ❑ <br /> Name: <br /> Property address: r4S,6 C2��L c.�yt-( <br /> Phone1: 52_ . '7 H c, Phone2: <br /> Email: <br />