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J <br /> 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 ❑ NoV <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 in your basement? Yes ❑ No Don't Know ❑ No ,bet <br /> avMedi <br /> Name: t`U/NA +Iv CA"( c-z (acy <br /> Property ta�ddress: .1-(6\�j`�`ct✓lC.� �G"- /; <br /> Phone 1:-6 2.`5-1 3 �j-ct,[;C5 Phone 2: 2-� 344t"l <br /> Email: R-C--t-caocc-ft- .i.-)5 ', co <br />