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2013 LARGE STORM RESPONSE PAPER FORM CHECKLIST <br /> 4ETT <br /> Date of inspection:¶/6'/ q 3•-4 11 (3/4 Inspected By: (?f`?&A. ))Qc /AI'lr GGC er /I`d1^-n <br /> Address: 70 6 1_ V-reL b I I Service Request Number: Oa'( �3 3 <br /> Resident: /4 <br /> c 0,- Ale-FA e/ 0/' Owner? 52 YES ❑NO <br /> Phone Number: L-2-c 3 9-7- 4 3 2- Email:1/46 1 6A 6 -7-0 (ro"(frier Gai-i <br /> General Building Details: <br /> Is this building within the combined sewer area? I2KES ❑NO Does the building have a basement? ©YES ❑NO <br /> Does the building have a backwater valve(BWV)? L24S ❑NO (If yes)Was BWV installed through City program ES ❑NO <br /> 2 L�J Y <br /> -0? S ewer't:6 SI r €ri.,n <br /> Does the building have a sump pump? ❑YES E NO Does the building have a grinder pump? ❑YES B� <br /> Storm Event Details: <br /> Where did water entering building come from? SURFACE FLOW ❑GROUNDWATER ❑SEWER BACKUP-FIXTURES ❑UNKNOWN <br /> Details:60 I) CL 3 o4Cr=4.4 ak(? ,f,17 © l� pro Arty S i cA41(3 ad,sb ey)PLr i /34c2,,,'ri <br /> Where did water go within the building? ASEMENT PERIMETER ❑-BASEMENT NEAR FIXTURES ❑OTHER <br /> Details: !- 1 i'For 3- i cos F ol3 r'i aril" <br /> Site Observations: A / / <br /> Downspout/site grading issues noted: i G 1/"/t S?ot{/c S1 s 7 IL - ' U 1 / l iv rUR,t Sd f-a <br /> Building elevation relative to sewer and surrounding area issues noted:S 4?.erg /�-!!l..-„t A4 Z Uf 1.3 C.e fz y - <br /> Site pump issues noted: <br /> Historical Information I Other Information: <br /> Previous"flooding"issue Service Requests at address: tt //a ,/� n <br /> Previous"flooding"issues noted by homeowner: `K f` WU45 (/'GGtI— 6 ! jMGu1 l-'- t� 8-Q't <br /> Recent stormwater/sewer projects completed in area: (/ Proposed stormwater I sewer p�cts in area: <br /> Property owner interested in beginning City Backwater Valve Program at address:0 YES 0 NO Details: <br /> Notes: G,??J249,-r-S 'LAC eitet Iivo rti1 Cil3 l A 134.L fr Alt. J (, ,4P <br /> 0 �L iude4s- C13 v`S f nit Ltfed- Io S-61,1 /V' lin&'. / <br /> Revision:3 TRW 1 Thursday,September 05, 2013 <br />