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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prev Lion device must be installed on your <br /> sewer connection to comply with the new pxd'inance. Please help us verify that our <br /> information is correct by answering the;1igllewirrg questions about your property: <br /> Do you have a basement? Yes ZNo ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes f <lo ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know E( <br /> Do you have a grinder pump in your basement? Yes ❑ No II'6on't Know ❑ <br /> Name: ;PA/PA K% (7, <br /> Property address: 1 2— /(0S',-- gih <br /> Phone 1: �7i�-2S2i 785Z Phone 2: 2 4. Z7 3R7/ <br /> Email: C.,,,? /;:tie, v tj?4-; may( <br />