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1 . <br /> _BACKWATER PREVENTION DEVICE PROGRAM <br /> '"Our records indicate that a backwater prevention device must be installed on the sewer <br /> '4''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? Yess No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes AS 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 A Don't Know ❑ <br /> Name: /l irCs We 11-5 <br /> Property address: J 5,2 6 W Aj LI t!/— <br /> Phone 1: 9?5 2 3 2-10 I Phone 2: 2&D-6 9/-/o 4' <br /> Email: 1 h dr s 14 oh i Groin L'fl. Coyyl <br />