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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? Yegy 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 <br /> Do you have Oldr pump in your basement? Yes ❑ No ❑ Don't Know <br /> 4=. pc-vino <br /> Name: t4LX AN.Q Q — 9 <br /> Property address: 1� L ( {,i 6 <br /> Phone 1: 1c 3Ll 'cccI1/1-g Phone 2: <br /> Email: G k -eX?.0�eta v <br /> a t rf <br /> 1a <br />