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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? Yes"Li 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 a grinder pump`�iinn_your basement? Yes ❑ No El Don't Know <br /> Name: W o\ ?V"t <br /> Property address: 2 S Q,Q�n(�7 <br /> Phone 1:4d 500 1015 Phone 2: <br /> Email: W014 j�1 1(�1 e Qtf 1(.l. u can <br /> ' ' <br /> Y V <br />